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^ 1982 John C, Simoneaux
AN EVALUATION OF THE CLASSIFICATION OF HYPERKINETIC
CHILDREN WITH THE VIGILANCE TASX AND
THE MATCHING EAMILIAR FIGURES TEST
JOHN C. SIMONEAUX, B.A., M.A.
A DISSE'RTATION
Ilv'
PSYCHOLOGY
Submitted to the Graduate Eaculty of Texas Tecb University in Partial Fulfillment of tbe Requirements for
tbe Degree of
DOCTOR OF PHILOSOPHY
Approved
/ Accepted
August, 1982
ACKNOWLEDGEMENTS
I am deeply indebted to Professor Robert P. Anderson for his
direction of this dissertation and his guidance throughout my stay
at Texas Tech, I am also grateful to the other members of my com-
mittee, Professors Barnett, Bell, and Perez, and Assistant Professor
lacono for their helpful criticism, Finally, I thank Gayle for al-
ways being there.
n
CONTENTS
ACKNOWLEDGEMENTS ii
ABSTRACT vi
LIST OF TABLES viii
I. INTRODUCTION 1
Hyperactivity , 5
Background and Current Status , , 5
Prevalence , . . . , . , , . . , ~l
Symptoms 9
EtioTogy , , , , . , . , 10
Prognosis . . , , , . , , , , 13
Treatment l^
Current Diagnostic Practices , , , , ^
Interviews . , , , . , . . , l^
Individual Tests 19
Simple Performance Tests , 19
Higher Order Cognitive Tests , , . , . , 21
Laboratory Measures ^
The Vigilance Task . . . . . . , , , , . , , , 29
Rating Scales ... , . , , , . . . 31
Research Hypotheses . , , , , , . 33
II, METHODS AND PROCEDURES , , 35
Subjects . . , , , , 35
Apparatus . , , . , . . . . . , . , . , 'l
iii
Instrumentation 44
Matching Familiar Figures Test ... 44
The Rating Scale for Hyperkinesis 45
Behavior Checklist 45
Slosson Intelligence Test 46
Administrative Procedures . , . . , 46
Statistical Design 47
III, RESULTS , , . . , ^ 51 Hypothesis 1 ,
Hypothesis 2 ^
Hypothesis 3 , . , fi?
Hypotheses 4 and-5 . , , , ,
Hypothesis 6 ^'
Hypothesis 7 ^
Hypothesis 8 , , ^
Hypothesis 9 '^
IV. DISCUSSION , ^ •70
Hypothesis 1 , , . . , . , , . , . . . . , . . . , , ' Hypothesis 2 , ,
Hypothesis 3 , .
Hypotheses 4 and 5
. . » . , • • ' .
Hypothesi
Hypothesi
Hypothesi
Hypothesi
s 6
s 7
s 8
s 9
Implications
81
82
83
84
86
86
89
90
IV
Directions for Future Research 92
Limitations 93
V. SUMMARY AND CONCLUSIONS 96
REFERENCES 99
APPENDICES 118
A. Diagnostic Criteria for Attention Deficit Disorder
with Hyperactivity 119
B. . Parent Cover Letter (St. Joseph's) 121
C. Parent Cover Letter (Levelland) 122
D. Informed Consent Form 123
E. Zukow Hyperkinesis Rating Form 125
F. -Behavior Checklist 127
G. Conners' Abbreviated Teacher Rating'Scale 128
H. Test Report Form 129
I. Texas Education Agency Guidelines for Identifying
Learning Disabled Children 130
J. Vigilance Task Booth 132
K. Audiotape Recorded Instructions 133
L. Dissertation Record Sheet 134
ABSTRACT
The accurate diagnosis and placement of hyperactive children has
been recognized as critical in the planning and implementation of
psycho-educational interventions aimed at ameliorating the difficul-
ties these children inevitably encounter. The importance of correc-
tly identifying hyperactive children is underscored when the typical
interventions for treating the disorder are considered. The side-
effects of medication are sometimes worse than the disorder, Two
objective instruments (the Vigilance Task and the Matching Familiar
Figures Test) surfaced as potentially useful in diagnosing this dis-
order,
One-hundred children (27 hyperactives, 27 learning disabled, 46
"normals") were administered the Vigilance Task and the MFFT. Both
stepwise and direct discriminant analyses failed to demonstrate that
these tests had adequate discriminating abilities. Only 56% of the
children in the study were correctly classified when the yielded
discriminant function was applied. The most promising single mea-
sure was the correct detections score on the Vigilance Task which
presumably taps the attentional deficit component of hyperactivity,
The tests were found not to discriminate significantly better
when the subjects were made more homogenous (e,g,, sex, age), The
trend was for the scores of the larger group of hyperactives and
learning disabled children to be similar to each other and different
from the "normal" group. Scores on the two tests did correlate to
vi
some degree with each other in the expected directions, indicating
that they probably measure similar, or coexisting phenomena, Ade-
quate split-half reliability data were obtained for both instru-
ments, Teachers and mothers strongly agreed that the children in
the hyperactive group displayed hyperactive behavior patterns. A
slight relationship was found between Slosson IQ scores and correct
detections on the Vigilance Task,
v n
TABLES
1. Numbér of Subjects and Mean Age of Young/Old and Male/Female
Groups 36
2. Number of Subjects X Sex X Classification XXAge Group 39
3. Number of Subjects X Grade X Classification 39
4. Number of Subjects Tested by Time of Day 42
5. Classification by Day of the Week Tested 42
6. Kagan's Descriptors for MFFT Responders 44
7. Eigenvalues and Measures of Importance 52
8. Residual Discrimination and Test of Significance 53
9. Summary table for Discriminant Analysis Using Rao's V
Stepwise Procedure 55
10. Canonîcal Discriminant Function for Discriminant Analysis
Using Rao's V Stepwise Procedure 56
11. Standardized Canonical Discriminant Function Coefficients
(Rao's V) 57
12. Classification Results Using Rao's V Stepwise Method 58
13. Classification Results Using Full Discriminant Analysis
Methods 59
14. Standardized Canonical Discriminant Function Coefficients ... 60
15. ResuUs of Classifications for Various Subsamples 62
16. Means and Standard Deviations for Scores on the Vigilance Task
and MFFT for Hyperactive, Learning Disabled, and Normal Groups . 63
17. One-Way ANOVA Results from Three Groups on Correct Detections . 64
18. One-Way ANOVA Results from Three Groups on False Alarms . . . . 6;
vm
19. One-Way ANOVA Results from Three Groups on Latency 65
20. One-Way ANOVA Results from Three Groups on Errors 65
21. t^-Values and Probabilities for Scores on the Vigilance Task and
MFFT Scores 66
22. Expected Intercorrelation Directions of Vigilance Task and
MFFT Scores 67
23. Intercorrelations and Probabilities Between Scores on the
Vigilance Task and the MFFT 68
24. Intercorrelation Matrix for Teacher and Parent Ratings 70
25. Expected Correlation Directions for Test Measures and Teacher
and Parent Ratings 71
26. Obtained Correlation Coefficients for Test Measure and Teacher
and Parent Ratings 72
27. Descriptive Data Concerning Subject's IQ 73
28. t^-Tests Comparing IQ and Groups 75
29. Correlations Between IQ and Scores on the Vigilance Task and
the MFFT 75
IX
CHAPTER I
INTRODUCT ON
Hyperactive children are said to constitute the largest category
of child psychological referrals to mental health and pediatric facili-
ties (Ross & Ross, 1976), Their behavior is most frequently charac-
terized by motoric restlessness, poor attention span, impulsivity, and
a generally excessive activity level, One indication of the preva-
lence of hyperactivity is the observation that approximately 40% of
school age children referred to mental health clinics exhibited hy-
perkinetic behavior patterns (Kahn & Gardner, 1975). Hyperactivity
is certainly a problem of some magnitude,
The accurate diagnosis and placement of hyperactive children
has been recognized as critical in the planning and implementation of
psycho-educational interventions aimed at ameliorating the difficul-
ties these children inevitably encounter. A need for standardized
procedures in the assessment of hyperactivity has been demonstrated
by Berler and Romanczyk (1980), In a survey of seven major journals
which publish in areas related to hyperactivity it was found that
while learning disabled children tended to be selected on the basis
1
of standardized, objectlve tests, hyperactiye children were more fre-
quently identified through the'use of subjective indices. Qnly a
single study evaluated in the Berler and Romanczyk (.1980) eirticle used
a standardized instrument (the Kagan Matching Familicir Figures Test)
to assess hyperactivity. Forty-four percent of the investigations
employed a single teacher or parent rating scale to identify those
children with the disorder,
Teacher rating scales, used alone for diagnostic purposes, have
been shown to have questicnable validity. Kenny, Clemmens, Hudson,
Lentz, Cicci, and Nair (.1971) found that well over half of the children
referred by a school system to their diagnostic clinic were judged not
to be hyperactive by the evaluating staff. Anderson and his colleagues
(Langsdorf, Anderson, Wiechter, Madrigal, & Juarez, 1979: Waechter,
Anderson, Juarez, Langsdorf, & Madrigal, 1979) found that ethnicity
and social class influenced teacher ratings. Lower frequencies of
hyperactivity were noted in schools with white majorities while a
higher incidence was found in schools with black or Mexican-American
majorities, Langsdorf et al. (1979) explain these differences from
a sociological perspective. Findings such as these highlight the need
to differentiate between objective assessments of hyperactivity and
hyperactivity as "perceived" by a single teacher.
The importance of correctly identifying hyperactive children is
underscored when the typical interventions for treating the disorder
are considered, The medical treatment of choice for the management
of hyperactivity involves the use of cerebral stimulants or tran-
quilizers. While these procedures are frequently beneficial there
are often deleterious slde^ffect to the drugs, The development of
accurate diq^gnostic tools will result in a reduction in the numher of
children being placed on such medications unnecessarily.
The phenomenon of misattribution is another unfortunate concomitant
of faulty diagnoses, Hyperactivity is most frequently associated with
physiological axplanations of etiology, When this factor becomes most
salient to those working with the particular child, other relevant
contributions to the child's heightened activity level (e.g,, modeling,
reinforced behavior, excessively stimulating environments, emotional
disturbances) may be overlooked, When this occurs professionals will
find themselves treating the wrong problem. Williamson, Anderson, and
Lundy (1980) support this notion by proposing an ecological model
of hyperkinesis in which the antecedents of hyperactive behavior are
multiple, being provided by the child's familial, academic, and phy-
siological environments. As a result of this proposed înodel the authors
suggest that treatment should be multimodal, involving the child,
his/her family, and the school
Several writers (Berler & Romanczyk, 1980; Safer & Allen, 1976;
Walden & Thompson, 1981) have explicitly called for caution in the
diagnosis of hyperactivity. Further, these investigators have encou-
raged the development of standardized. objective procedures and bat-
teries for diagnosing this disorder. This cause has been aided of late
by recent changes in psychiatric diagnostic practices. Due to current
trends in research findings, a shift in nomenclature has recently
taken effect. With the publication of the •Diagnostic and Statistical
Manual of Mental -Disorders, Third Edition (DSM III; American Psychi-
iatric Association, 1980), what was once commonly identified as the
hyperactive syndrome is now referred to as Attention Deficit Disorder
with Hyperactivity (ADD), This change is based primarily on programs
of research by Douglas (1972), Dykman, Ackerman, Clements, and Peters
(1971), and others.
The most frequently cited primary symptoms of ADD are hyperac-
tivity (overactivity, restlessness), inattention (distractibility,
forgetfulness), impulsivity (recklessness, inability to delay grati-
fication), and excitability (irritability, low frustration tolerance),
The complete DSM III diagnostic criteria can be found in Appendix A,
Several objective instruments exist which have been designed
to measure certain of the characteristics of hyperactive children.
The Vigilance Task, for example, has been utilized to obtain objective
indices of inattention and impulsivity (Anderson, Halcomb, &Doyle,
1973). Kagan's Matching Familiar Figures Test (MFFT) has been widely
cited (e.g., Campbell, 1973; Campbell, Douglas, & Morgenstern, 1971;
Hopkins, Perlman, Hechtman, & Weiss, 1979; Juliano, 1974) as a useful
instrument for identifying the impulsivity component of ADD,
In light of the need for objective measures of attention defi-
cit disorder, and the recognition that multiple indices are desirable
when measuring characteristics such as impulsivity and attention
(Paulsen & Johnson, 1980), the present study aims to assess the pos-
sibility of meeting this need through the use of the two instruments
mentioned above. This investigation will seek to determine if a
5 5
discriminant analysis procedure, involving the Vigilance Task and the
MFFT as predictor variables can result in an accurate and objective
classification procedure for hyperactive children,
Hyperactivity
Background and Current Status
Descriptions of children who would now be diagnosed as hyperac-
tive date back 80 years or more (Ebaugh, 1923; Still, 1902). Through-
out the 1930s and 1940s various investigators proposed etiological
theories involving organic brain damage (Bradley, 1937; Kahn & Cohen,
1934; Orton, 1937; Strauss & Lehtinen, 1947), Much of the early re-
search proceeded from the assumption that organic pathology was re-
sponsible for the hyperkinetic child's atypical behavior. Although
it seemed obvious that brain trauma and neurological disease could
produce hyperactive behavior patterns, it became equally clear that
many children who had been diagnosed as hyperactive did not possess
unequivocal organic pathology. The term minimal brain dysfunction
(MBD) came into use to indicate the presence of one or more symptoms
considered to reflect the presence of subtle cerebral abnormalities,
As a result of the apparent dead-ends to which the pursuit of
the MBD concept was leading, an increasing number of investigators
began to deemphasize organic etiological considerations in favor of
other explanations, For some this represented the choice of a be-
havioral model; hyperactivity was viewed as a behavioral-psychological
phenomenon rather than as a syndrome, or as one symptom of a medical
6 6 5
disorder, For others the inodel remained a medical one, and the use
of the terms hyperkinetic or hyperactive child syndrome signified
prtmarily that no single organic etiology accounted for cin hyperac-
tivlty,
A hy-product of the shift in terminology was an increase in con-
cern with the definition of hyperactivity, It began to be evident
that the essential difficulty of these children was with attention
rather than actiyity. Research by Dyktnan et al. (1971) and Douglas
(.1972) clarified this central role of inattention. The American Psy-
chiatric Association (1930) formally recognized these findings with
the aforementioned shift in nomenclature,
A fundamental difficulty with an activity level focus in hyper^
kinesis research is semantic. Cromwell, Baumeister, and Hawkins (1963)
noted that all responses made by an organism can be defined as activity.
Some investigators'have constructed empirical measures in order to
establish operational definitions of the hyperactive's characteristic
restlessness (Schulman, Stevens, & Kupst, 1977; Stevens, Kupst, Suran,
& Schulman, 1978). This research team's device consisted of a small
electronic package, worn at the waist, which measured activity by the
angular displacement of mercury switches. The device had adjustable
biofeedback potential; It has been found to be a reliable measure of
activity level in the classroom, Another technique is to monitor
movement from place-to-place by using photo-cells to measure the number
of times a child crosses c beam of light. This would result. however,
in a much different index from one obtained by measuring how much a
child moves while sitting in a chair. These and other measures.
7
not been found to correlate well with one another (Cromwell et al.,
1963). Due to discouraging research findings, as well as the difficul-
ties involved in deciding what forms of behavior constitute "activity",
the trend in more recent investigations has been in the direction of
focusing on cognitive elements of the disorder,
Prevalence
Wender (1973) has estimated that there are over five million
children in the United States who are identified as hyperactive, The
disorder is estimated to occur in as many as 3% to 5% of prepubertal
children (American Psychiatric Association, 1980; Ross & Pelham, 1981).
The symptoms of hyperactivity apparently manifest themselves in some
form yery early in the child's life, Campbell, Schleifer, and Weiss
(1978) found that there were continuities in both maternal reports of
behavior during early childhood and later elementary school behavior,
A large portion of the children referred for mental health services
exhibit hyperkinetic behavior patterns (Kahn & Gardner, 1975; Patterson,
Jones, Whittier, & Wright, 1965), Hyperactive children often perform
poorly in school, are aggressive, and have poor peer relationships
(Rosenthal & Allen, 1978). Their symptoms create problems which may
lead to poor adjustment later in life. In addition, hyperactive
children's behavior is often disruptive to their parents, families,
teachers, and classmates,
Estimates of the prevalence of hyperactivity are highly variable,
ranging from two to three percent of all children (Sprague, 1977) to as
many as 50% of all boys (Werry & Quay, 1971). Because many definitions
8 M 5
of hyperactivity have been offered, ranging from highly clinical and
subjective to entirely objective and operational, much of the varia-
bility in prevalence figures can be attributed to differences in
terminology and perspective,
Physicians frequently serve as the identifying agents for hyper-
active children. Most typically the variables considered relevant for
diagnosis include (a) symptom behaviors that are common to hyperkinesis, , , ,
(b) the sources of information available, and (c) responses to pro-
grams of medication, The usual scenario involves the parent reporting
the his/her child has been engaging in hyperkinetic behavior. The
physician examines the child, noting that indeed he/she is quite rest-
less. Hyperactivity is then diagnosed and the "appropriate" medication
is prescribed. Occasionally physicians will refer, when the resource
is available, to a psychologist or to the child's school for assistance
in confirming the diagnosis.
Parents and teachers are often the first link in the diagnostic
chain. When they are asked to describe children by checking lists of
descriptors, as many as half of all elementary school boys may be
identified as restless and inattentive (Lapouse & Monk, 1958; Werry
& Quay, 1971), Teachers rate children differently with regard to
ethnicity (Langsdorf et al,, 1979; Waechter et al., 1979).
When scores on rating scales are used to estimate prevalence, the
number of children considered hyperactive will be a direct function of
the cut-off point chosen. In a normal distribution of scores a cut-
off point two standard deviátions above the mean will identify two to
three percent of the sample as hyperactive (Sprague, 1977). As a
result, there may exist significant differences with regard to the
number of children recognized as having problems severe enough to re-
quire treatment. The numbers involved in the latter group of children
could well be deflated due to a lack of economic resources on the
parents' part to seek and receive treatment for their child.
Many writers and clinicians are disturbed by the fact that
definitions of hyperkinesis vary more across situations and across time
than does the hyperkinetic child. Experts seem to agree on terminology
(Schrager et al,, 1966) more than they do in practice (Kenny et al.,
1971), Clearly the presence of childhood hyperactivity is accepted
in the literature concerning behavioral disorders in children. An
orderly ajid unified approach to its assessment and diagnosis must pre-
cede a more settled state of knowledge about prevalence, etiology,
treatment, and course. The accurate identification of hyperactivity
is critical for the children who are involved and essential if mean-
ingful research is to be undertaken concerning its treatment.
Symptoms
The term hyperactivity, although widely used and accepted, has
been found to not accurately describe the problems of these children,
Cognitive aspects of the disorder are beginning to be emphasized
rather than the child's activity Tevel, While the disorder is offi-
cially (DSM III) referred to as Attention Deficit Disorder with Hyper-
activity, the terms hyperactivity and hyperkinesis will be used in
the present study in order to facilitate expression, The cognitive
components of the disorder will be assumed when using these terms.
10
The primary symptoms of hyperkinesis have been noted above and
the diagnostic criteria can be found in Appendix A. One or more sec-
ondary symptoms have been identified as being associated with hyper-
activity. Lists enumerating these secondary symptoms typically include
low self-esteem, academic skill deficits, and delinquent behavior,
Several authors (Morrison & Stewart, 1971; Safer & Allen, 1976; Wender,
1971), however, consider learning difficulties and aggressive behaviors
to be primary symptoms. Cantwell and Satterfield (1978) lend support
to the presence of learning difficulties in hyperkinetics. They re-
ported that a greater percentage of hyperactive children underachieved
in reading, spelling, and arithmetic when compared to non-hyperactive
children,' The hyperactives tended to be behind in more different sub-
jects and by more grade levels than were normals.
Etiology
Several factors have been identified as being responsible for
the presence of hyperactivity, The traditional explanation of some
sort of brain pathology or trauma resulted from observations of World
War I veterans with confirmed brain injury, Difficulties in attention
and emotional control were often noted. Due to similar symptoms in
those children exhibiting hyperactive behavior it was assumed that
this disorder also resulted from brain injury (Hallahan & Kaufman,
1976). Johnson (1981) reviewed this research and found little evi-
dence supporting the notion that organic factors play a significant
part in hyperactivity, Hyperactivity is certainly one possible symp-
tom of brain damage, Not all hyperactives, however, are brain damaged,
11
nor are all brain damaged individuals hyperactive,
Psychogenic factors have been proposed as having etiological
significance in hyperactivity. The implication is that child rearing
practices, direct reinforcement, and/or modeling are responsible for
the presence of hyperkinesis. It has been demonstrated that many
hyperactives display their problematic behavior at an early age
(Campbell et al., 1978; Stewart & Olds, 1973), Several investigators
(Henderson, Dahlin, Partridge, & Engelsing, 1973; Zinna, 1979) have
proposed a temperament pattern model resulting from the early mother-
child interactions, It is evident from this work, however, that tem-
perament alone does not produce hyperactivity.
Social reinforcement may serve to perpetuate hyperactive behavior,
It is not uncommon for high activity Tevels to be reinforced (through
attention for example) on a regular schedule through adolescence,
Several clinicians (Morrison & Stewart, 1971; Willerman & Plomin, 1973)
have noted that the parents of hyperactive children are often hyperac-
tive themselves. The implication is that heightened activity level
is learned through modeling. Kaspar and Lowenstein (1971) showed
that less active children, after a 20-minute free play period, increased
their activity level to approach that of their more active playmates.
A highly active parent may have a profound effect. While this argu-
ment is intuitively appealing there has been little empirical re-t
search published in i t s support. ^
Other environmental factors discussed in re la t ion to the i r pos-
s ib le e t io log ica l contr ibut ion to hyperkinetic behavior include lead
12
poisoning and radiation stress (Johnson, 1981). While lead poisoning
does seem to be linked to disturbances in brain metabolism (David,
Clark, & Voeller. 1972; David, Hoffman, Sverd, Clark, & Voeller, 1976;
Silbergeld & Goldberg, 1973, 1974; Wiener, 1970), no causal relation-
ship has been demonstrated between hyperactivity and increased body
lead levels, Ott (1974) postulated that exposure to flourescent
lighting and unshielded television tubes can result in radiation ex-
posure of sufficient intensity to cause hyperactivity, Hartley (1974)
conducted a study with rats which confirms this idea. Mayron, Ott,
Nations, and Mayron (1974) compared conventional and shielded flou-
rescent lighting in a 90-day experiment with school children. The
hyperacttve children's attention span and behavior improved only in
the shielded flourescently lighted class. Painter (1976) found a
32% drop in activity with the removal of flourescent lights. Research
in this area shows promise and deserves greater attention.
Ross and Pelham (1981) summarize etiological research by noting
that it is replete with ambiguity. It is pointed out that the various
hypotheses are not mutually exclusive, and that the proposed mechanisms
probably interact. Weiss and Hechtman (.1979) agree, concluding that
the syndrome can best be understood in terms of interactions between
social, psychological , and biological variables. It may be that
different "types" of hyperactivity exist, hence, different etiologies.
Ney (1974) has observed at least four subtypes of hyperkinesis, At
best, the present state of our knowledge concerning the etiology of
hyperactivity can be characterizec as uncertain.
13
Prognosis
A note about the prognosis of hyperactivity is in order because
it also underscores the need for accurate diagnoses, Traditionally it
has been believed that hyperactive children cease to experience prob-
lems once puberty ensues, Several researchers have cited evidence to
the contrary, Heussy and Cohen (1976) reported that 50% to 70% of
hyperactives have failed at least one school grade and half of them
failed two grades by the time adolescence is reached, Twenty-five
to 60% drop out of school before graduating, In a fonow-up on 15
adolescents who had been diagnosed as hyperactive five years before,
Hoy, Weiss, Minde, and Cohen (1978) found that they performed worse
than controls on sustained attention visual-motor and motor tasks,
and on two of four reading tests. The hyperactives assigned them-
selves lower ratings on self-esteem and sociability items. It appears
from this data that hyperactives at adolescence continue to suffer
from attentional and stimulus processing difficulties that affect
both their academic and social functioning,
Mendelson, Johnson, and Stewart (1971) noted that two-thirds of
adolescent hyperactives have serious-discipline problems at home and
at school, with higher rates of suspensions and expulsions than non-
hyperactives. From 25% to 60% have had contact with legal authori-
ties (Weiss, Minde, Werry, Douglas, & Nemeth, 1971) and more hyperac-
tives are prone to alcohol abuse (Blouin, Bornstein, & Trites, 1978),
Morrison (1980) reported that, as adults, hyperactives tended to have
less education, lower work status, and a higher rate of violence and
14 \
legal problems than psychiatric controls, Morrison (1980) sees these
difficulties as resuUing from failures of parental control rather
than being an effect of hyperactivity.
It is clear from this evidence that the problems of hyperactives
do not cease with the onset of puberty. Less is known about the fate
of hyperactive children once they become aduUs. In any case, it is
evident that hyperkinetic children are at risk for a variety of dif-
ficuUies in their later years. The development of early, accurate
diagnostic techniques and effective treatment methods for this dis-
order is crucial,
Treatment
There is little doubt that the existence of the CNS stimulant
drugs, primarily Ritalin and Dexedrine, contributed to the increase
in hyperkinetic diagnoses. A prescription often serves to relieve
the parents' worries about their possible responsibility for the devel-
opment and maintenance of their child's difficuUies, A medical syn-
drome provides an explanation that is external to both parents and
child (Whalen & Henker, 1976). Thus, more and more children were
diagnosed and treated, In addition, changing societal factors may
have contributed to genuine increases in hyperactive behavior (Block,
1977) and thus to increases in medical diagnoses and treatment.
The medical treatment of choice for the management of hyper-
activity involves the use of cerebral stimulants or tranquilizers.
Concern has been expressed that these children are medicated for the
teacher's convenience in order to resolve classroom difficuUies
15
chemically (Safer & Allen, 1976), Walden and Thompson (1981) note
that many problematic behaviors that are defined by teachers, such
as restlessness, attention seeking, disruptiveness, and distractibi-
lity are so prevalent in elementary school children that inappropriate
labeling becomes common. Schuckit, Petrich, and Chiles (1978) confirm
this in their findings which indicate that an inaccurate use of hyper-
active labels was frequently found in difficult to handle children.
Frequently other diagnoses, rather than hyperactivity, would be
more appropriate for particular children. Staton and Brumback (1981)
complain that children are frequently medicated for "hyperactivity"
when, in fact, the hyperactivity is only a secondary symptom of another
disorder.-' They note, for example, that primary childhood depression
is sometimes associated with hyperactivity, Staton and Brumback (1981)
explain that "hyperactives" are quickly medicated without an adequate
differential diagnostic evaluation.
The correct diagnosis of hyperactivity becomes critical when
pharmacological interventions are being considered, The presence of
side-effects caused by drugs used to control the disorder may resuU
in more difficuUies than benefUs when inappropriately utilized.
Sequelae ranging from annoying to serious have been noted in approxi-
mately one-third of the children to whom drugs have been given (Walden
& Thompson, 1981). These side-effects include: loss of appetite,
sleeplessness, depression, withdrawal, cardiac changes, and retar-
dation of height and weight gain (Firestone, Poitras-Wright, & Douglas,
1978), Sandoval, Lambert, and Sassone (1981) estimate that 85?. of
16
those children identified by physicians as hyperactive received a
prescription for medication for at least six months at some time during
their lives,
Several classifications of drugs have been used to treat hyper-
activity; the psychostimulants, the mood aUerators, and the neurolep-
tics. Each has been associated with various side-effects,
Common psycho-stimulants which are prescribed include methyl-
phenidate hydrochloride (Ritalin), pemoline (Cylert), amphetamine
sulfate (Benzedrine), and dextroamphetamine suUate (De3(edrine), Over
40 side-effects associated with the use of amphetamines have been
listed (Goodman & Gilman, 1975), If a side-effect persists the phy-
sician wi-ll usually shift to Ritalin or Cylert in an effort to elimi-
nate the problem,
The tricyclics, amitriptyline hydrochloride (Elavil), imipramine
hydrochloride (Thorazine), and haloperidol (Haldol), are used generally
in more difficuU cases of hyperactivity. The incidence and intensity
of their side-effects are markedly greater, however, and some physicians
have been reluctant to prescribe them.
Axelrod and Bailey (1979) warn of the careless use of drug
therapy. They note that many of the research results are conflicting,
that side-effects are often worse than the disorder, and that medica-
tions sometime have paradoxical effects, O'Leary (1980) agrees, citing
his research which demonstrated that psychopharmacological treatment
often resulted in short-term changes in social behavior but not in
long-term shifts in academic or social behavior.
The diagnosis of hyperactivity can be differentially affected by
17
ethnic and/or social factors. Langsdorf et a1., (1979) and Waechter
et al., (1979) found increased incidences of perceived hyperactivity
in lower socioeconomic groups as well as in certain ethnic minorities.
Stevens' (1981) data supports this finding, noting that perceived
socioeconomic status and ethnic identification of assessees influenced
the assessor's attributions of hyperkinetic behavior. The importance
of these incorrect diagnoses is underscored when the deleterious side-
effects of the preferred treatments are considered.
The keen interest in pharmacological studies has indirectly lim-
ited research on assessment instruments. Sandoval (1977) explains
that the bulk of the literature deals with the evaluation of medica-
tions for use with hyperactive children, As a resuU of this focus,
extensive data on reliability and validity of research instruments
is not available. Typically instruments are used simply as part of
a standard assessment battery administered to each child and are not
selected particularly for a hyperactive study.
This discussion makes it clear that the proper diagnosis of hyper-
activity can be critical. The hurdles to overcome may be more pervasive
than has been implied above. Robin and Bosco (1976) write that the
different relevant social systems (schools, families, medicine) work
to obstruct the proper diagnosis and treatment of hyperactivity.
Conrad (1974) agrees and goes further by discussing the social impli-
cations of the medicalization of hyperactivity. Williamson et al..
(1980) have proposed a model of hyperkinesis which takes into account
family and academic environments as well as physiological environments.
In short, a physiological etiology of hyperkinesis may prove to be
18
excessively simplistic. Appelbaum (1975) encouraged a muUidimensional
diagnostic procedure, including a neurological examination, psycholo-
gical testing, interviews, detailed medical and behavioral interviews,
and an assessment of the family's functioning.
The consequences of mislabeling can at best be merely incon-
venient and at worst catastrophic. The possible implications of a
fauUy diagnosis go beyond merely the side-effects of medications.
Important influences on a child's heightened activity level may go
unnoticed as a consequence of the blinders resuUing from pharmacolo-
gical interventions.
Current Diagnosti-c Practices
A major issue in the assessment of hyperactivity is the identifi-
cation and evaluation of methods of measurement. Numerous assessment
methods have been used or proposed. Poggio and Salkind (1979) appraised
nine instruments designed to ass'êss the disorder, Most were found to
have serious flaws. Few follow-up studies exist which examine norma-
tive, validity, and reliability data, This section will examine the
various diagnostic practices used, including (a) interviews, (b) indi-
vidual tests, (c) laboratory measures, and (d) rating scales.
Interviews
Interviews, during which a parent (usually the mother) is asked
about the child's development and current problems, are often utilized
in the diagnosis of hyperactivity. Both informal and semi-structured
formats for such interviews have been developed, Interview formats
can consist of specific questions, or of lists of specific topical
19 }
areas to be covered, with questions of the interviewer's choice.
Golinko (.1978) suggested the use of the Behavioral Interview, a spe-
cific set of questions answered by the parents, which is designed to
differentiate hyperactive children from non-hyperactives, Rutter and
Brown (1966), after comparing several different interview strategies,
asserted that the parent interview can be a primary source of descrip-
tive diagnostic information about the child. They explained that
despite the fact that parents' perception of their children are sub-
jective and unsystemmatic, their exposure to the child's behavior
over a period of years and in many situations makes them potential
experts on these matters, There is cause, however, to be cautious
about the validity of retrospective material culled from the parent
interview (.Yarrow, Campbell, & Burton, 1970).
Individual Tests
Sandoval (1977) divides tests used to assess hyperactivity into
two groups: (a) simple performance tests, such as the Bender Visual
Motor Gestalt Test, the Frostig Developmental Test of Visual Perception,
the Human Figure Drawing Test, and the Porteus Maze Test, and (b) higher-
order cognitive tests, such as the Wechsler Intelligence Scale for
Children (WISC and WISC-^R), the Embedded Figures Test (EFT), and the
Matching Familiar Figures Test (MFFT), Projective tests and children's
personality inventories are used less frequently,
SimpTe performance terts - The Bender Visual Motor GestaU Test
has been utilized in hyperactivity research since receiving a good
score is dependent on plsnning skills as well as attention to detail,
20
characteristics frequently absent in hyperkinetic children. The
measure, however, is apparently not successful in distinguishing
hyperactive from normal children (Palkes & Stewart, 1972), Dyckman,
Ackerman, Peters, and McGrew (1974) did demonstrate that the test,
under certain conditions, could differentiate between learning dis-
abled and normal children. The Bender-GestaU apparently does measure
impulsivity in some children, but there are perhaps other instruments
which provide better indicants.
Certain subtests of the Marianne Frostig Developmental Test of
Visual Perception have been found to be able to differentiate medi-
cated from non-medicated hyperactive children (Sandoval, 1977). The
Frostig apparently taps some elements of certain hyperactive charac-
teristics, In particular, the figure-ground test requires attention
to detail in the face of distracting stimuli. The test, as a whole,
requires the child to resist responding impulsively, an act that would
presumably be difficult for hyperactives. .
Drawing tests have been used as measures of attention to detail
with hyperactives, It is presumed that anti-hyperactivity medication
would positively affect attention, concentration, and impulsivity,
and hence improve performance on such tests. Palkes and Stewart (1972)
found hyperactives scores lower on the Figure Drawing Test than normals
after partialling out WISC IQ scores. Further, Millichap, Aymat,
Sturgis, Larsen, and Egan (1968) noted that the drug effect was
strongest for children who had initially scored low on the drawing
test, but were otherwise average in intelligence.
The Porteus Maze Test consists of a series of progressively more
21
difficult mazes that yield an iq and a Qualitative, or Q score. The
former has been shown to differentiate hyperactive from normal sub-
jects (Spring, Yellin, & Greenberg, 1976) and to be drug sensitive
(Conners, Eisenberg, & Sharpe, 1964; Conners & Rothschild, 1968;
Conners, Rothschild, Eisenberg, Schwartz, & Robinson, 1969; Conners,
Taylor, Meo, Kurtz, & Fourmer, 1972; Epstein, Lasagna, Conners, &
Rodriguez, 1968). The Q score has not been found to be drug sensitive
(Epstein et al., 1968; Rapoport, Ouinn, Bradbard, Riddle, & Brooks,
1974), Palkes, Stewart, and Kahana (1968) demonstrated, however, that
training of hyperactive boys in verbal mediation to inhibit impulsive
behavior was reflected in improved IQ and Q scores on this test.
Higher order cognitive i:ests - Several instruments, all of which
presumably tap more complex cognitive processes than those mentioned
above, have been investigated with regard to their ability to identify
hyperactive children. The most commonly used tests in this category
include the Wechsler Intelligence Scale for Children (WISC and WISC-R),
the Embedded Figures Test (EFT), and the Matching Familiar Figures
Test (MFFT). The WISC has been used primarily as an index of improve-
ment in attention and concentration. The EFT is a measure of Field
Dependence-Independence, while the MFFT assesses Reflection-Impulsivity.
Despite its widespread use in clinical applications the WISC has
not been investigated in any depth with regard to identifying subtest
patterns peculiar to hyperactive children. More studies have been
completed which examine the Performance, Verbal, and Full Scale IQ
scores for different groups,
22
Keogh, Wetter, McGinty, and Donlon (1973) analyzed WISC subtest
groupings including Verbal Comprehension (Information, Vocabulary,
and Comprehension), Analytic-Field-Approach (Object Assembly, Block
Design, and Picture Completion), and Attention-Concentration (Arith-
metic, Digit Span, and Coding). Hyperactive subjects tended to score
lower on the Attention'rConcentration score, but not on the other
scores. Palkes and Stewart (1972) found that controls scored signi-
ficantly higher than hyperactives on the Similarities, Picture Com-
pletion, and Mazes scores. IQ scores were also significantly higher
in controls,
Studies involving simply Verbal, Performance, and FuU Scale IQ
scores have yielded mixed resuUs, Medicated groups scored better
than placebo groups on Performance IQ in some investigations (Epstein
et al,, 1958; Knights & Hinton. 1969; Page, Bernstein, Janicki, &
Michelli, 1974) but not in others (Conners et al., 1969; Conners et al.,
1972; Conrad, Dworkin, Shai, & Tobiessen, 1971; Finnerty, SoUys, &
Cole, 1971). Knights and Hinton (1969) noted improvement in only the
Picture Completion, Block Design, and Coding subtests. Epstein et al.,
(1968) saw improvement in all subtests.
The WISC's ability to differentiate hyperactive from normal
children is questionable at best. Sandoval (1977) sees the instru-
ment as both inappropriate and unjustified as a measure of attention
and concentration, given the availability of other measures.
Field-dependence, as measured by the EFT (Witkin, 1959), has been
presumed to measure one aspect of hyperactivity, that being distracti-
bility. Field dependent children, in theory (Campbell et al,, 1971),
23
have more difficuUy, due to their increased leyel of distractibility,
acting on a problem (locating a figure in a confused and distracting
context in the case of the EFT) than do fieldT-independent children,
While there is some evidence that hyperactives are more field depen-
dent than controls, performance on the EFT is not markedly influenced
by medication (Campbell et al., 1971; Cohen et al., 1972; Schleifer,
Weiss, Cohen, Elman, Cvjic, & Kruger, 1975; Winsberg, Bialer, Kupietz,
& Tobias, 1972). The EFT is not an unequiyocal measure of attention-
distractibility,
Kagan's Matching Familiar Figures Test (MFFT) has been one of the
most frequently used research instruments in the investigation of hyper^
activity. Its construction is based on the observations that some
individuals select and report solution hypotheses quickly and with mini-
mal concern for their probable accuracy, while others, of equal intelli-
gence, take more time to decide about the validity of their solutions.
The impulsive strategy has been proposed to be correlated with learning
disabilities, specifically hyperactivity, The basic task on the MFFT is
for the subject to choose the one of six facsimile items that is identi-
cal to a standard (an iHustration of a familiar object). All fac-
similes (save for one) differ from the standard in at least one de-
tail. The critical variables scored are response time to the subject's
first answer and the total number of errors across the 12-item test.
Impulsivity is recognized as one of the three major charácteris-
tics of children diagnosed as having and attention deficit disorder
(Douglas, 1976; American Psychiatric Association, 1980). The MFFT has
been the primary research tool used to measure this behavior.
24
Hyperactive children have been said to represent the extremes
of impulsive behavior as described by Kagan (1966). They make de-
cisions too rapidly, fail to consider possible consequences, and sieze
the first response that comes to mind. The fact that hyperactive
children represent this extreme has been confirmed empirically
(Campbell et al., 1971), Keogh and Donlon (1972) recommended a con-
sideration of the presence of impulsivity as a necessary condition
for a diagnosis of hyperactivity. . Further, they suggested that
Kagan's MFFT be included in the standard assessment battery for hyper-
activity.
Regarding the reliability of the MFFT, there are four studies
in which^children six to 10 years of age were retested on the same
version of the MFFT after periods of one to eight weeks. Response
time reliabilities were .58, .68, .73, and .96, corresponding error
reliabilities were .39, .34, .43, and .80 (Adams, 1972: Duckworth,
Ragland, Sommerfeld, & Wyne, 1974; Hall & Russell, 1974; Siegelman,
1969). Epstein, Cullinan, and Lloyd (1977) found that the instrument
had a high level of stability over time. Block, Block, and Harrington
(1974) reported an internal consistency reliability coefficient for
MFFT response time of .89.
An extensive literature exists establishing the construct validity
of Kagan's test. Margolis, Leonard, Brannigan, and Heverly (1980) re-
ported data supporting the construct validity of the MFFJ as an index
of reflection-impulsivity, Rovet (1980) found the instrument to sig-
nificantly differentiate between previously ideniified (through means
other than the MFFT) impulsive and reflective groups.
25
In four studies (Campbell et al., 1971; Cohen, Douglas, &
Morgenstern, 1971; Rapoport et al,, 1974; Schleifer et al,, 1975) the
MFFT was shown to differentiate hyperactive children of various ages
from control children. In addition, all four studies demonstrated
that the impulsivity score is influenced by active psychostimulants.
Juliano (1974) has also reported a greater ratio of impulsives to re-
flectives among hyperactives as compared with normal children.
MFFT scores have been found to be related to several of the di-
agnostic criteria characteristics of hyperactivity. Reflective four-
and eight-year-old children sustáin attention in play longer than im-
pulsives (Campbell, 1973). Impulsive pre-schoolers are likely to
start and stop their activities, and to chat or roam between activities;
reflectives sustain attention even while chatting (Messer, 1976).
The ability of reflectives and impulsives to sustain attention has
also been explored by testing their reaction time with a variable inter-
val between the signal to "get ready" and the presentation of the stimu-
lus to which they are to respond (Zelniker, Jeffrey, AuU, & Parsons,
1972). As predicted, no difference between impulsives and reflectives
was observed on the short preparatory intervals, On the longer inter-
vals, however, impulsives took longer to respond, suggesting their
greater reluctance, or inability, to sustain attention in a laboratory
task.
On a modification of Buss's aggression machine, seven-year-old
impulsive boys displayed more aggression than did reflectives (Thomas,
1971). This suggests that impulsives exercise less behavioral control
as well as less cognitive control. Mann (1973) has reported that
26
reflective first^graders were more likely to choose delayed rewards
than were impulsives, Impulsives tended to opt for immediate rewards.
If the concept of reflection-impulsivity has generality, re-
flectives and impulsives should remain reflective and impulsive on
tests similar to the MFFT as well as in other test situations containing
response uncertainty. Yando and Kagan (.1970) used 10 different matching
familiar figures tests, each with a different number of facsimile fig-
ures (ranging from two to 12). Despite increasing levels of complexity
most children retained their relative rank on both response time and
errors.
Two other tests used to explore the generality of reflection-
impulsivity are the Design Recall Test (DRT) and the Haptic Visual
Matching Test (HVMT; Kagan, Rosman, Day, Albert, & Phillips, 1964),
In the DRT geometrical forms are used, and the subject must choose the
correct aUernative from his/her memory of the standard, which is
viewed first and then removed. The standard in the HVMT is either a
three-dimensional geometrical form or a familiar object that the sub-
ject feels but does not see, the correct aUernative again being chosen
from memory. Response times to the MFFT, DRT, and HVMT are moderately
intercorrelated, with intercorrelations ranging from .33 to .52
(Kagan, 1965; Kagan, Pearson, & Welch, 1966; Kagan et al., 1964).
Raven's Coloured Progressive Matrices involves the subject se-
lecting the correct variant from an array of six variants that will
complete a matri^. Hall and Russell (1974) found the MFFT latency
scores correlated .54 with mean latency to choice of variant on the
Raven.
27
The above data appear to support the contention that the MFFT
may be a useful ins'trument in the identification of hyperactive child-
ren. Based on research evidence it surfaces as the most potentially
accurate measure for this purpose, It is for these reasons that the
MFFT is utilized in this study as one of the two instruments of in-
terest.
Laboratory Measures
Specialized performance measures have been explored in labora-
tory settings with regard to the information they can yield about
hyperactivity. A group of investigators have looked at measures of
automatic functioning that is subject to distraction; the Stroop Color
Distraction Test and the Santostefano and Paley Colour Distraction Test.
The task is for the subject to read a color-name in the presence of
a distracting factor, the color of the ink. It was found that these
tests did not differentiate hyperactive children from controls
(Campbell et al., 1971; Cohen, Weiss, & Minde, 1972) nor were they
drug sensitive.
Millichap and Fowler (1967) suggested that direct measures of
activity be included in evaluation studies of hyperactive behavior.
Attempts at such measurements have involved the use of a room fitted
with photoelectric cells (Ellis & Pryer, 1959) or uUrasonic sensors
(McFarland, Peacock, & Watson, 1966), placing a child's desk on a
suspended platform fitted with movement sensors (Foshee, 1958), and
placing a radio transmitter in a helmet worn by the child (Davis,
Sprague, & Werry, 1969; Herron & Ramsden, 1967). It should be noted.
28
however, that most of these investigations involved mentally retarded
children, In hyperactivity research three devices have been commonly
used; the actometer, the activity recorder, and the stabilimetric
cushion, They are, respectively, a modified seU-winding wristwatch
(the actometer), a two-dimensional pedometer-type device attached to
the child's shirt back (the activity recorder), and a cushion embedded
with microswitches to detect movement while seated (the stabilimetric
cushion),
The actometer proved to be very reUáble when attached to a
machine (Schulman & Reisman, 1959) but unreliable when attached to
a child (Johnson, 1971), The actometer has been used in three clinical
tests of Jîiedication by Millichap (Millichap & Boldrey, 1967; Millichap,
Aymat, Sturgis, Larsen, & Egan, 1968; Millichap & Johnson, 1974) with
mixed resuUs.
The activity recorder has been validated with hyperactive child-
ren in that it has been found to distinguish between teacher-judged
hyperactive and non-hyperactive boys (Victor, Halverson, Inoff, &
Guczkowski, 1973), but it does not appear to be drug sensitive
(Rapoport, Abramson, Alexander, & Lott, 1971). The stabilimetric
cushion not only differentiated between groups (Sykes, Douglas, Weiss,
& Minde, 1971) but was also drug sensitive to the stimulant Ritalin,
aUhough not to the tranquilizer thioridazine (Sprague, Barnes, &
Werry, 1970; Sprague, Christensen, & Werry, 1974).
Because of the presence of instrument unreliability, the expense
of the equipment, the obtrusive nature of some instruments^ and the
problem of determining and/or controlling the context of measurement
29
in a field study, direct measures of physical activity are less at-
tractive than other diagnostic jnstruments.
The Vigilance Task
Attentíon deftcits and impulsivity are two of the major behavioral
components in the diagnosis of ADD (American Psychiatric Association,
1980). Several investigators (Bakan, 1966; Jerison, 1967; Mackworth,
1968) have proposed that a vigilance paradigm lends itseU to answering
questions about the nature of attention.
The typical vigilance study is structurally very similar to many
detection and discrimination experiments. An observer is presented
with stimuli, some of which are to be reported, Specific parameters
of vigilance experiments include, (a) the vigil is maintained for ex-
tended periods (usually one-half hour or longer), (b) signals are pre-
sented infrequently and unpredictably, and (c) the signals are psycho-
physically strong (i.e., they are nearly always reported correctly by
a normal population with virtually no false alarms, but weak in a sub-
jective sense because they are not "attention demanding." The observer
must be continuously alert in order to report all signals accurately.
Detection failures are usually identified as failures of attention.
One concern in using a vigilance procedure with small children
is the issue of stimulus complexity. Jerison (1967) argued that sim-
plicity must be utilized in vigilance tasks in which the problem is to
decide whether or not a specific stimulus is a signal. He called for
the discontinuance of the use of complex sensory analyses such as
search, scanning, or memory from the study of detection of a signal
in a vigilance paradigm.
30
Numerous vigilance studies have been conducted investigating
individual differences in the normal population with regard to vigi-
lance, Examples of such research include signal probability and stimu-
lus density (Jerison, Pickett, & Stenson, 1965), unwanted signals
(Colquhoun, 1961), signal rate differences (Jenkins, 1958), and rein-
forcement expectancy (Deese, 1955),
The hypothesis that the requirements of a vigilance task would
pose difficuUy for hyperkinetic children has been supported by several
investigators (Anderson, Halcomb, Gordon, & Ozolins, 1974; Doyle,
Anderson, & Halcomb, 1976; Kaspar, Millichap, Backus, Child, & Schulman,
1971; Sykes, Douglas, & Morgenstern, 1972). Hyperkinetics have been
shown to jdetect fewer correct signals and produce more false responses
than controls. Thus, it appears that hyperkinetic children have greater
than average difficulty in sustaining their attention to a continuous
performance task than do controls (Rosenthal & Allen, 1978; Sykes et
al., 1973).
Anderson et al., (1973), using the same vigilance task employed
in the present study, demonstrated that the instrument effectively dif-
ferentiated learning disabled children from normals on correct detec-
tions and false alarms. The study also suggested that a hyperactive,
hypoactive, normoactive distinction might be made.
In a later study, Anderson et al., (1974) utilized the vigilance
task to measure the effects of medication on attentional deficits in
hyperactive children. The resuUs indicated that hyperactive children
between the ages of six and eight scored more correct detections while
on medication than when off.
31
Several other investigators at Texas Tech University have used
the Vigilance Task with learning disabled and/or hyperactive children,
Doyle (1973) utilized the instrument to investigate the effects of dis-
traction and attention deficits among children with learning disabi-
lities. He concluded that the Vigilance Task provided a systematic
means with which to investigate attention deficits in children with
learning disabilities.
Ozolins (1974) studied the effects of knowledge of resuUs on
the vigilance performance of hyperactive and hypoactiye children with •
learning disabilities, It was found possible to alter a child's
arousal level by manipulating which information about resuUs was
dispensed,
Finally, Langsdorf (1980) used the Vigilance Task as one cri-
terion variable in order to identify a hyperactive group. In this
study, three measures were obtained during the Vigilance Task; correct
detections (a measure of attentional abilities), false alarms (impulsi-
vity), and an activity count (a measure of motoric restlessness),
Rating Scales
Paper-pencil rating scales are frequently used as screening in-
struments for the identification of hyperactivity and sometimes play
an integral role in the diagnosis of individual cases. Scales to be
completed by the child's teacher are most commonly used, Given their
training and experience base teachers are considered to be more re-
liable raters than would be parents, Several studies attest to tea-
chers' ability to identify children who will behave deviantly during
classroom observations (Bolstad & Johnson, 1977; Bowers, 1978; Jones,
32
Loney, Weissenhurger, & Gleischmcinn, 1975; Sprague & Gadow, 1976).
A teachers' rating scale developed by Conners [1969) is the most
frequently cited instrument of this kind. It exists in two forms:
(a) a 39-item form with five factorially derived scales (aggressive
conduct disorder, inattention, withdrawal, hyperactivity, and social
ability), and (b) a 10-item form, either administered separately or
embedded in a larger version. Norms and validation for the Conners
scale are presented by Werry, Sprague, and Cohen (1975). A significant
correlation between the Conners scale and observation of children's
behavior in the classroom was demonstrated by Cristensen (1975),
Sprague (1977) suggests the use of a cut-off score of 15 (two standard
deviation's above the mean) on the Conners abbreviated scale to identify
probable hyperkinetic children. Numerous investigators have used that
guideline in screening referrals.
Copeland and Weisbrodal (1978), using the Conners scale, found
that it successfully tapped observable dimensions of hyperactivity in
novel situations. Zentall and Barack (1979) investigated validity
and reliability issues. High correlations were noted which suggested
that there existed excellent predictability between the scale and
stability across time and rater,
The Zukow Hyperkinesis Rating Form (Zukow, Zukow, & Bentler,
1978) has been used for parental ratings of hyperactivity (Langsdorf,
1980). It consists of 28 behavioral items in a forced-choice format,
yielding three factor clusters: Excitability, Motor Coordination, and
Directed Attention. Zukow et al., (1978) note that the items included
in the Excitability cluster are most similar to those characteristics
33
of hyperactivity that are most typicc^lly descrlbed,
The most common conclusion abouf hyperactivity is that diagnostic
information should be sought from various perspectives and sources,^
The hope is that the resuUs of numerous procedures from various sources
win converge on a single diagnostic conclusion and that some clear eti-
ology or treatment direction win emerge if enough diagnostic clues are
unearthed. This diagnostic advice derives from several facts; (a) the
inconsistency and variability of the hyperkinetic child's behavior, (b)
the continuing ambiguity surrounding the diagnosis of hyperactivity, (c)
the fact that hyperactivity may have several causes (Fish, 1971), and
(.d) the measures, tests, and scales available for the assessment of hy-
peractivity are generany only indirect indices of hyperkinetic behavior
patterns.
-Research Hypotheses
It is evident from the above discussion that the availabinUy of
objective and reliable means of classifying hyperactive children ac-
curately would serve to faciU'tate the ameU'oration of many problems
associated with their treatment and education. The extant n'terature
points to two instruments which show promise in differentiating hyper-
active and non-hyperactive children, i.e,, the Vigilance Task and the
Matching Familiar Figures Test. This study aims to assess their use-
fulness, when combined, in classifying children in a hyperactive, non-
hyperactiye dimension. The foHowing hypotheses encompass the specific
research questions of interest in this study:
1, Scores on the Vigilance Task and the Matching FamiUar Figures
Test can yield discriminant functions which accurately and consistently
34
differentiate hyperactive from non'-hyperactive children,
2, Neither the Vigilance Task nor the Matching Familie^r Fig-
ures Test alone can accurately and consistently differentiate hyper-
active from non-hyperactive children.
3, There win be no sex or age differences with regard to the
discriminant functions' abiUty to classify hyperactive, learning dis-
abled, and normal children accurately,
4. Hyperactive children win obtain quantitatively different
scores on the Vigilance Task and the Matching Famin'ar Figures Test
than learning disabled and "normal" children,
5, Normal children win obtain quantitatively different scores
on the Vigilance Task and the Matching Famin'ar Figures Test than hy-
peractive and learning disabled children.
6, Scores on the Vigilance Task and the Matching Familiar Fig-
ures Test win be significantly correlated (in the appropriate direc-
tions), This assumes that they are measuring similar, or coexisting
phenomenon in research subjects.
7. The Vigilance Task and the Matching Famin'ar Figures Test win
demonstrate adequate split-haU ren'abinty figures.
8. Teacher and parent ratings win be significantly correlated
(in the appropriate directions) with each other and with scores on the
Vigilance Task and the Matching Famin'ar Figures Test,
9. There win be no relationship between subjects' Slosson IQ
scores and performance on the Vigilance Task and the Matching Famin'ar
Figures Test.
CHAPTER II
^ METHODS AND PROCEDURES
The present chapter describes the methodological procedures uti-
n'zed to investigate the research hypotheses. The fonowing topics are
discussed: (a) subject characteristics, (b) apparatus, (c) instrumen-
tation, Cd) procedures, and (e) statistical design.
Subjects
The subject population consisted of 100 Caucasion elementary
school students, ranging in age from five years-six months to 11 years
six months (X age = 8.78). Subjects were controned for race due to
possible differences in referral rates among various ethnic groups
(Langsdorf et al,, 1979; Waechter et al,, 1979). Further, no subjects
were included who were currently being treated for hyperactivity medi-
cally, thus eliminating any possible pharmacological confounds. The
sample was divided into two approximately equal-sized subsamples made
up of younger children (5-6 to 8-6, N = 51, X age = 7.35) and older
children (8-7 to 11-5, N = 49, X" age = 10.27), Fifty-two percent of
the subjects were male, 48% were females. The young group was composed
of 42% males, 58% females. The old group had 62% males and 38% females.
Table 1 summarizes the population data.
The Leyenand Independent School District in Levenand, Texas. and
St. Joseph's CathoU'c School in Slaton, Texas served as referral sources
Cover letters (see Appendices B and C) were sent to an parents at St.
35
36
YOUNG GROUP
N
Mean Age
OLD GROUP
N
Mean Age
Table 1
Number of Subjects and Mean Age of
Young/Old and Male/Female Groups
MALE^
22
7.36
30
10.30
FEMALE
29
7.35
19
10.25
Joseph's (N = 94) asking them to allow their children to participate.
In Levenand administrators, principals, counselors, and teachers were
asked to submit names and addresses of children who they thought might
meet the requirements for inclusion in this study, Further, the South
Plains Educational Co-op (SPECO; the special education department of the
Levenand Independent School District) provided data (names and ad-
dresses) of those children who had been classified as learning disabled
and who were receiving some form of special education services. The
parents of all of these children were sent cover letters explaining
the project and asking for their participation (N = 87).
Once parents agreed to anow their children to serve as subjects
(N = 55. 58 ; in Slaton: N = 62, 71% in Levenand) they were asked to
37
sign a consent form (see Appendix D) and complete two paper-pencil
forms aimed at assessing their child's hehavior. These forms included
the Zukow Rating Scale for Hyperkinesis (see Appendix E; Zukow et a1.,
1978) and a behavior checklist (see Appendix F) based on the diagnostic
criteria listed in DSM III for Attention Deficit Disorder with Hyper-
activity (see Appendix A). These forms, as wen as the ratings pro-
vided by the child's teachers, served to identify those in the hyper-
active group. A n children in the study, however, were rated on these
forms. The forms themselves are discussed more fully in the Instru-
mentation section of this chapter.
It should be noted that the seemingly low return rates are de-
ceiving., Many of the children were cuned from the study prior to
the return of the forms for various reasons other than the denial of
permission to participate, e.g,, medical treatment for hyperactivity,
race, age, etc. Virtuany all of those parents asked agreed to their
child's participation in the study.
Teachers at St. Joseph's school and three of the four elementary
schools in Levelland, as wen as elementary school counselors and ad-
ministrators in both systems, were asked to complete two forms on a n
of the children they teach or serve. These forms included the behavior
checklist described above, and the Conners' Teacher Rating Scale
(Conners, 1969; see Appendix G). Sandoval (1977) suggested asking
teachers to rate the entire class, rather than simply those suspected
to be hyperactive, in an effort to avoid having the raters become
particularly sensitive to that child's behavior. Every precaution
was taken to avoid having the teachers associate the derivation of
38
the "hyperactive" U s t with these ratings. A period of several weeks
elapsed between the derivation of the n'st and the request for ratings.
Furthermore, the latter task was performed, for the most part, by SPECO
personnel, while the obtaining of the n*st from which parents were
notified was undertaken by the experimenter. Only ratings of children
whose parents had consented to allow participation were utin'zed.
Forms rating children for which consent was not procured were destroyed.
From this sampUng 48 potentiany hyperactive children and 36
learning disabled/non-hyperactive children were identified. Consents
and completed questionnaires were obtained from 40 (83%) in the hyper-
active group and 34 (94%) in the learning disabled group. Of these
children'27 hyperactives met the criteria (see below) for hyperactivity
and completed an procedures. Twenty-seven of the learning disabled
group also completed a n procedures, The majority of these children
(96%) were located in the Levenand Independent School District. There
were two children who met the hyperactive criteria at St. Joseph's.
Additionany, a group of 46 students from St, Joseph's completed a n
procedures and were included in the study. This sample largely con-
stituted the non-hyperactive/non-learning disabled group.
Once a n forms were completed appointments were arranged in order
to administer the Slosson Intenigence Test, the Matching Famin'ar
Figures Test, and the Vigilance Task, In all cases these instruments
were administered in school buildings. Details of procedures are dis-
cussed below. Immediately upon completion of a n testing a report
form (see Appendix H) and interviews (when requested) were provided
for the children's parents.
39
Suhjects in the discriîninant ancilysis phase of the inyestigí^tion
were divided into three groups based on varying criteria, These three
groups included: (a) a hyperactive group, (b) a learning disabled group,
and (c) a "normaV,'.' non-hyperactive, non-learning disabled group.
Breakdowns for these groups can be found in Tables 2 and 3. The cri-
teria for inclusion in each group were as fonows:
Table 2
Number of Subjects by Sex X
Classification X Age Group
Hyperactive Lng. Disabled Normal
Male Female Male Femal^ Male Female
Young 5 8 7 7 10 14
Old 11 3 7 6 12 10
Table 3
Number of Subjects X
Grade X Classification
GRADE
Classificatton 1 2 3 4 5 6 SeU-<:t)ntained
Hyperactive 2 3 3 6 5 3 3 2
L, D. 2 4 5 4 3 7 2 0
Normal 4 7 13 11 2 9 0 0
40
1, Hyperactive group. To be placed in the hyperactiye group
it was required that the child satisfy the diagnostic criteria as set
forth in DSM III and evaluated by the behavior checklist (see Appendix
F), This checklist was completed by three respondents (one parent
(mother) and two teacher/counselors) for each child. Inclusion in
this group required agreement by a n three raters that the child
satisfied DSM III criteria.
In addition to this standard, at least two raters must have
agreed on a hyperkinetic rating based on the Zukow Hyperkinesis Rating
Form (mother) and/or the Conners Teacher Rating Scale. It was felt
that the utin'zation of rigid, multiple criteria would resuU in the
identification of only those children who consistently exhibited hy-
perkinetic behavior patterns, Children who were rated as hyperactive
by some of the raters (but not up to the criteria) were not utin'zed
in the study (N = 1 0 ) ,
2. Learning disabled group. This group was included due to
the observation that hyperkinetic children are frequently identified
as learning disabled and vice^versa. Lambert and Sandoval (1980) noted
that 42.6% of hyperactives who achieved below grade level were eligible,
on the basis of objective criteria, for a learning disabled diagnosis.
An effective instrument for diagnosing hyperactivity should have the
abinty to differentiate these groups on the basis of the presence or
absence of hyperactivity, apart from the presence of other learning
disabiU'ties.
For the purpose of the present 5tudy this group was identified
in terms of the criteria defined by the Texas Education Agency as
41
indicative of learning disabled children. A complete statement of
these criteria can be found in Appendix I.
A n subjects included in the learning disabled group were dieig-
nosed by the South Plains Educational Co^p as learning disabled, and
did not meet any of the criteria for being placed in the hyperactive
group, The aim was to identify hyperactive learning disabled children
as wen as hyperactive non-learning disabled children.
3, The "normal" group was^procured from the student body at
St, Joseph's school (aUhough two hyperactive students were identified
at this school), Identical procedures were employed with this group.
In order to be included subjects in this group could not satisfy any
of the crjteria for placement in the other two groups, No more than
one of the six ratings obtained could identify the child as hyperac-
tive, otherwise the child was not included in the study. This occurred
with only two subjects. Further, teachers were asked to screen out any
students that had the sn'ghtest possibin'ty of suffering from a learn-
ing disabin'ty of any sort.
The administration of a n procedures was scattered across both
time and day of the week (see Tables 4 and 5). This served to control
for any possible temporal biasing effect.
Apparatus
The Vigilance Task is an instrument which has frequently been
used by researchers and clinicians at Texas Tech University to assess
possible hyperkinesis. It has been described in detail by Anderson,
Halcomb, and Doyle (.1973). Basicany, the tas involves the child
attending to a series of visual events occurring over time.
\2
Tahle 4
Number of Subjects Tested
By Time of Day
TIME OF DAY .NUMBER OF SUBJECTS TESTED
8:00 - 9:00 a.m, 8
9:00 - 10:00 a.m. 17
10:00 - 11:00 a.m. 16
11:00 - 12:00 a.m. 17
12:00 - 1:00 p.m. 9
1:00 - 2:00 p.m, 18
2:00 - 3:00 p.m. 12
3:00 - 4:00 p.m. 3
Table 5
Classification by Day of th,e Week Tested
DAY OF THE WEEK
Monday
Tuesday
Wednesd^y
Thursday
Friday
Hyperactive
5
7
3
6
6
^ CLASSIFICATION
Lng. Disa
3
5
5
9
5
ibled ^Normal
6
9
9
14
8
43
The Vigilance Task consists of a visual display (5 cm X 10 cm)
of red and green U'ghts (see Appendix J for an inustration), Verbal
instructions weré provided by means of an audio recorder (see Appendix
K for script) in order to insure standardization, While sitting at a
console (approximately 1,2 m X 1,2 m) the subject observes a pair of
flashing U'ghts. The n'ghts flash in combinations of red-red, green-
green, red-green, or green-red once ever two seconds. The stimulus
duration is .2 seconds. When a red-green or green-^red combination ap-
pears, the subject is instructed to press a button mounted on a bicycle
handlebar grip, A response is scored a correct detection when the
button is pressed immediately foUowing the presentation of a red^green
or green-j^ed combination. Responses to pther combinations (i.e., red-
red, green-green) are scored as errors or false alarms. In the pre-
sent study two scores were computed for each child, the total number of
correct detections and the total number of errors. Responses were re-
corded electronicany by a counter. A printed record was produced as
wen.
A five-minute practice period preceded each administration of
the Vigilance Task. A task identical to the actual Vigilance Task was
presented save for a different (7,5) variable ratio schedule, The pur-
pose of this practice period was to insure that the child funy compre-
hended the task at hand. If it became evident that the child did not
understand the tape was replayed and the practice continued until it
was clear that the desired response was understood,
During the 30-minute experimental period. 900 total red^red,
green-green, or red-green combinations we' e presented. Sixty of these
44
presentations were red-green Ccorrect detection) combinations. The
redr^green comhinations .were presented on a variable ratio 15 schedule,
with a total of 10 red-green combinations in eacK of the five-minute
intervals recorded by the counter. All other presentations were of
the red-red, green-green variety. The entire sequence of flashing
n'ghts was controned by a digital control system.
Instrumentatitjn
Matching FamiU'ar Figures Test
The school age children's form of the MFFT was used for this study,
The test format involved simuUaneous presentations of a figure (e.g,,
a boat, a pair of scissors. a telephone) with six facsimiles differing .
in one or,more details. On each of the test's 12 items the subject was
asked to select from the aUernatives the one that exactly matched the
standard. If an incorrect response was given the child was informed
of this fact and asked to try again. Correct responses were verbally
reinforced, Time to the first response (latency) and the number of er-
rors for each card were recorded.
Typicany subjects administered the MFFT are classifed on the
basis of a 2 X 2 matrix in which reflective andimpulsive children are
those who fall in two diagonal cens (see Table 6). Messer (1976)
Table 6
Kagan's Dcscriptors for MFFT Responders
RESPONSE TIME ACCURATE INACCURATE
Fast Fast Accurate Impulsive
Slow Reflective Slow Inaccurate
45
suggested that the most appropriate procedure was to treat the data in
a continuous rather than a dichotomous manner. This anows latency
and error to be employed as continuous variables, thus avoiding the
hazards of dichotomization as wen as allowing for calculation of the
amounts of variance contributed separately by latency, error, and their
interaction, This is the manner in which the data were conected and
analyzed in the present study,
The Rating Scale for Hyperkinesis
The Rating Scale for Hyperkinesis (Zukow et al., 1978) is made
up of 28 items in a forced-choice format. It yields three factor
clusters: Excitability, Motor Coordination, and Directed Attention.
Zukow et. il. (1978) noted that the items defining the Excitabin'ty fac-
tor are similar to the characteristics of hyperactivity that are typi-
cany described. Langsdorf (1980) found, in using this scale, that
mothers of hyperactive children attributed more hyperkinetic charac-
teristics to their children than did mothers of two other non-hyperac-
tive groups.
This form (Appendix E) was completed by the mothers of an
children in the subject population. For the purposes of this study
ratings were considered hyperactive if the responses of the child's
mother to the first item (Unusually hyperactive: Home School Both No)
was rated in the "hyperactive" direction and the majority of items in
the Excitabin'ty cluster were endorsed.
Behavior Checkn'st
The behavior checklist has been derived entirely from the DSM
III diagnostic criteria for Attention Deficit Disorder with Hyperactivity
46
(see Appendices A and F). It should be noted that these criteria are
expU'cit as to what symptoms should be present in order to identify
hyperactivity, These standards are the same which win apply for the
purposes of this study.
A n raters were asked to complete the behavior checklist for each
child. In order for a child to be placed in the hyperactive group all
raters must have agreed that the child satisfied these criteria.
Slosson InteUigence Test
The Slosson Intenigence Test (SIT) is a brief individual intel-
ngence test consisting of items adapted from-the Stanford-Binet.
Items are presented verbally and, with a few exceptions, require a
verbal response. The test takes approximately 20-minutes to admini-
ster. The SIT was used in this study to get a quick yet reasonably
van'd measure of each subject's level of intellectual functioning,
Administration Procedures
Once a n consent forms and ratings were returned arrangements
were made for testing the child. This testing was completed either
at St, Joseph's School or the South Plains Educational Co-op building,
In both cases the apparatus was located in a room free from distractions
and interruptions,
After a brief rapport-estabn'shing chat the child was admini-
stered the MFFT, The SIT was given immediately fonowing the MFFT.
At this point the subject was offered the opportunity to take a bath-
room break, being told that the next task must be uninterrupted. The
child was then escorted to the Vigilance Task apparatus and instructed
47
to be seated, Instructions for the Vigilance Task itseU were recorded
on an audio tape in order to insure uniformity. The practice portion
of the tape was presented after which the practice was initiated.
Upon completion of the practice the remainder of the audio tape was
presented tsee Appendix K for script) and the testing session was be-
gun. It continued until the Vigilance Task was completed. The entire
procedure required approximately one to Ih hours to complete,
A n data for each subject were recorded on a standard data sheet
(see Appendix L) designed to facin'tate coding into a computer format.
A n raw data (including the data sheet, the Vigilance Task printout,
the SIT scoring sheet, teacher and parent ratings, and consent forms)
were numericany coded and filed,
Parents were provided with feedback on the resuUs of the test.
A brief report form (see Appendix H) was provided to explain the find-
ings for their child. The reports were written with an explicit state-
ment concerning the experimental nature of these instruments. An offer
was made on the report, as well as verbany whenever possible, to dis-
cuss the resuUs personally with the child's parents on request. Sev-
eral parents requested such an interview and they were held as soon
after the testing as possible. All parents of participating children
received at least written feedback within two days of testing,
Statistical Design
The primary statistical procedure in this study involved the
appn'cation of discriminant analysis computation. This design involves
two stages: (a) the assignments of each subject to the appropriate
diagnostic group, i.e., normal, learning disabled, hyperactive (this
48
was accompnshed through the use of the various r^tings obtained from
teachers and parents), (b) the assessment stage at which time the pre-
dictor, or discriminating variables are administered.
The question at hand is essentiany one of classification, i,e.,
can the groups be differentiated on the basis of the scores obtained
on the set of discriminating variables? The objective of the analysis
is to determine the degree to which a child's profile of scores on a
set of tneasures corresponds to or resembles the typical profiles of each
of a given set of discrete classes. Specificany, the primary re-
search question involved determining if the two scores yielded by the
Matching Familiar Figures Test, along with the two scores yielded by
th'e Vigilance Task, provided accurate discrimination between hyperac-
tive and non-hyperactive children.
Discriminant analysis attempts to do this by forming one or more
n'near combinations of the discriminating variables. These "discrimi-
nant functions" are of the form:
D. = d.jZj + d.^Z^ + . . . + d.pZp
Where D- is the score on discriminant function i, the d's are weighting
coefficients, and the Z's are the standardized vaTues of the p discrimi-
nating variables used in the analysis. The maximum number of functions
which can be derived in this investigation is two. Ideany, the dis-
criminant scores (D's) for the cases within a particular group win
be fairly similar. At any rate, the functions are formed so as to max-
imize the separation of the groups. Once the discriminant functions .
have been deriyed, one is able to pursue the two research objectives of
this technique: analysis and classification.
49
The analysis aspects of the technique proyide statistical tests
for measuring the success with which the discriminating varisibles actu-
a n y discriminate when combined into the discriminant functions, Since
the discriminant functions can be thought of as the axes of a geometric
space, they can be used to study the spatial relationships among the
groups. Finany, the weighting coefficients can be interpreted much
the same as in muUiple regression of factor analysis. They serve to
identify the variables which contribute most to differentiation along
the respective dimension.
The use of discriminant analysis as a classification technique
comes after the initial computation. If a set of variables resuU
which pravides significant discrimination for cases with known group
memberships, a set of classification functions can be derived which
win permit the classification of new cases with unknown memberships.
As a check of the adequacy of the discriminant functions the
original set of cases can be classified to see how many are correctly
classified by the variable being used, The procedure for classification
involves the use of separate linear combinations of the discriminating
variables for each group. These produce a probabin'ty of membership
in the respective group, and the case is assigned to the group with
the'highest probability.
Often there are more discriminating variables than are necessary
to achieve satisfactory discrimination. A stepwise procedure is typi-
cany used to select the most useful of the discriminating variables,
In this study both direct and stepwise analyses win be computed.
Additionany, several other computations win be made, in the
50
form of t^-tests, correlations, and ANQVAs in order to investigate some
of the secondary hypotheses. These analyses are discussed, in detail,
in the ResuUs section of this study,
CHAPTER III
RESULTS
The primary research hypotheses pertain to the usefulness of
scores on the Vigilance Task and the Matching Familiar Figures Test
in predicting group membershio, Specificany, the issue in question
is whether or not these scores can work to classify children accurately
into hyperactive and non-hyperactive groups. Discriminant analysis
was chosen as the most appropriate statistical tool for analyzing this
data. The SPSS (Statistical Package for the Social Sciences) subpro-
gram DISCRIMINANT (Klecka, 1975) was selected to perform this analysis.
The analysis yields, in both direct and stepwise fashion, discriminant
functions, which produce a probabin'ty of membership for each subject
in the respective groups; the case, then is assigned to the group with
the highest probabin'ty of membership,
The findings for each of the stated hypotheses are presented
separately, The first five related hypotheses are considered to en-
compass the major questions at hand and thus win be discussed in some
detail,
Hypothesis 1
The first hypothesis deals with the yielded discriminant func-
tion's ability to differentiate hyperactive from non-hyperactive child-
ren, based on scores on the Vigilance Task (correct detections and false
alarms) and the MFFT (latency and errors),
In this study, with three groups and four variables, the analysis
yielded two discriminant functions. The question is whether or not.
' 52
either or hoth of the discriminant functions yielded can wprk to dif-
ferentiate hyperactive from non-hyperactive children, The relative
utinty of each of the functions can he assessed by the data in Taible 7,
Table 7
Eigenvalues and Measures of Importance
FUNCTION
1
2
EIGENVALUE
.24973
.00340
PERCENT OF VARIANCE
98.65
1.35
CANONICAL CORRELATION
.4470186
.0582502
The first eigenvalue of .24973 is more than 73 times larger than
the eigenvalue for the second function. This indicates that the second
function is \/ery weak in relation to the first. It can be seen that
the first function contains 98.65% of the total discriminating power
in this pair of equations.
A high canonical correlation coefficient indicates that a strong
relationship exists between the groups and the discriminant function.
Table 7 indicates that there is a moderate degree of relationship be-
tween the groups and the first function (relative to the second), and
virtually no relationship between the groups and the second function
(relative to the first). This means that the first function is more
powerful, in a relative sense, than the second. If the groups are not
wery different on the variables being analyzed, than all of the cor-
relations win he low. From the data contained in Table 7 it appears
that only function 1 is meaningful and at best it win have only mar-
ginal utility in explaining group differences.
53
Wilk's lambda is a muUivairiate measure of group differences
over several variables (the discriminating variables). Values of lambda
denote d, high discrimination as they approach zero. Table 8 presents
this data,
Tabile 8
Residual Discrimination and
Tests of Significance
FUNCTIONS DERIVED
0
1 -
WILK'S LAMBDA
.7974593
.9966069
CHI SQUARED
21.614
0.325
DEGREES OF FREEDOM
8
3
SIGNIFICANCE LEVEL
.0057
.9553
Evidently the three groups of subjects scored somewhat differently
on at least some of the discriminating variables. This is evidenced by
a Wilk's Lambda of .7974593 which has significance at the .0057 level.
After the first (and most powerful) function is derived a good deal of
discrimtnating information is removed from the system, At this point
Lambda becomes ,9966069. This very high value indicates that any re-
maining information about group differences may not be worth pursuing.
This data demonstrates that the groups are somewhat different on their
scores on the Vigilance Task and the MFFT and that the first function
provides the bulk of the discriminating information. The remaining
function is either unimportant or statisticany spurious.
Given that hyperactive, learning disabled, and normal children do
score somewhat differently on these instruments the question which fol-
lows is whether or not these scores are different enough to anow
54
consistently accurate classifications of the children based on the
scores alone. Since there were unequal numbers of subjects in each
group (Hyperactive N = 27, Learning Disabled N = 27, Normal N = 46,
Total N = 100) it would have been more probable that a particular sub-
ject would have been assigned to the normal group before he/she would
have been assigned to one of the other groups, In order to control
for these inequities adjustments for prior probabilities were made in
the analysis. These adjustments were particularly important with this
data because there existed considerable overlap among the groups (e,g,,
hyperactives scoring like normals, learning disabled children scoring
n'ke hyperactives, etc.)
Given the experimental questions implicit in this study a step-
wise procedure designed to yield a measure maximizing total group sepa-
ration was most appropriate. Rao's V measures the separation of group
centroids and does not concern itseU with cohesiveness within the
groups. The goal of this study was to maximize the differences between
the scores of hyperactive, learning disabled, and normal groups, hence,
Rao's V stepwise procedure was chosen. A fun analysis was also per-
formed in order to evaluate the discriminating abin'ties for a n of the
discriminating variables.
As a resuU of the application of Rao's V procedure two variables
(correct detections and latency) had significant discriminating power.
The resuUs of this analysis are summarized in Table 9.
It can be seen from the data in Table 9 that correct detections
on the Vigilance Task was the measure with the maximum discriminatinc
abilities. Latency on the MFFT does add some measure of unique discrim-
inating ability to the discriminant function, The change in Rao's .. V
to
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57
resulting from the inclusion of the latency score is not, however,
significant.
T^ble 10 indicates that wery n'ttle of the variables' discrimi-
nating abin'ties remain after correct detections and latency contribu-
tions are accounted for. Function 1 accounts for 99.27% of the variance
when these two variables are used. The addition of either or both of
the other two variables Cfalse alarms and errors) would have added
virtuany nothing to the discriminating abin'ty of the function.
The canonical correlation of function 1 is a measure of the
function's ability to discriminate among the groups, The canonical
correlation squared (in this case .1903093) can be interpreted as the
proportion of variance in the discriminant function explained by the
groups. Thus it can be seen from Table 10 that the first discriminant
function is moderately correlated with the groups but the second has
a yery low correlation,
The standardized discriminant function coefficients are of ana-
lytic importance in and of themselves (see Table 11). When the sign
Table 11
Standardized Canonical Discriminant
Function Coefficients (Rao's V)
MEASURE FUNCTION 1 FUNCTION 2
Correct Detections
Latency
1.02223
-0.40537
.15216
.95068
is ignored each coefficient represents the relative contribution of its
58
associated variable to that function. Thus, in Table 11 it can be seen
thac correct detections is about 2H times as important as latency 1n
the first function. Latency makes the greatest contribution 1n the
second functlon but it must be remembered that this function has n'ttle
discriminatinq power.
Given a n of the above, how good is the resuUant discriminant
function at classifying children into the appropriate categories?
Table 12 summarizes the classifications resulting from the use of Rao's
V stepwise selection t iethod.
Table 12
Classification Results Using
Rao's V Stepwise Method
NO. OF ACTUAL GROUP CASES
Hyperactive 27
Learning Disabled 27
Normal 46
PREDICTED
HYPERACTIVE
1 3.7%
2 7.4%
0 0.0%
GROUP MEMBE^SHIP LEARNING DISABLED
8 19.6%
12 44.4%
4 8.7%
NORMAL
18 16.7%
13 48.1%
42 91.3% •
Percent of "Grouped" Cases Correctly Classified: 55.00%
Table 12 illustrates the ineffectiveness of the function at cor-
rectly classifying children on the basis of Vigilance Task and MFFT
scores. Only 1 (3.7%) true hyperactive child was correctly placed in
the hyperactive group; the majority were identified as norman A greater
proportion of learning disabled (44.4%) and normal (91.3%) were
59
correctly placed. The high latter figure results, in part, froin the
fact th^t 73% of the total sample was classified normal. It ^ppears
from these data that scores, in general, tended to be more "normal"
than deviant. This discriminant analysis resuUed in only 55% of the
total sample being correctly classified. The tests seem to quite ac-
curately classify non-hyperactive children as norman, they also, how-
ever, tend to misclassify hyperactive and learning disabled children
as normal.
This (Rao^s V) stepwise procedure utin'zed only those variables %•
which maximize total group separation. When fun discriminant analysis
procedures were applied (i.e,, utilizing all of the discriminant vari-
ables) the resuUs were virtuany identical (see Table 13). The
Table 13
Classification ResuUs Using
FuTl Discriminant Analysis Method
NO. OF ACTUAL GROUP CASES
Hyperactive 27
Learning Disabled 27
Normal 46
PREDICTED
HYPERACTIVE
3 11.1%
1 3.7?:
1 2.2%
GROUP MEMBERSHIP
LEARNING DISABLED
8 19.6%
12 44.4%
4 8.7%
NORMAL
16 59.3%
14 48.1%
41 89.1%
Percent of "Grouped" Cases Correctly Classified: 56.
standardized discriminant function coefficients (see Table 14) demon-
strate that correct detections and latency are. again, the most heavily
Tablea4
Standardized Canonical Discriminant
Function Coefficients CFun)
60
MEASURE FUNCTION 1 FUNCTION 2
Correct Detections
False Alarms
Errors
Latehqy
.91389
.19761
.12060
.44817
-.01443
-.68821
.51208
.76755
weighted factors, with false alarms and errors carrying very n'ttle
weight, -Other stepwise procedures (WHk's Lambda, Mahalanobis squared
distance between closest groups, minimizing residual variance, maxi-
mizing the smallest F ratio between pairs of groups) an yielded re-
suUs identical to those noted in Table 12.
It must be noted that as with any inferential technique based on
sample data the percent correct prediction tends to overestimate the
power of the classification procedure. This is because the validation
is based on the same cases used to derive the classification functions.
The equation utilizes idiosyncratic sampling error to create classifi-
cation functions which are more accurate for that particular sample than
they would be for the full population. As a resuU, the figures shown
in Tables 13 and 14 are somewhat inflated-and the discriminant functions'
classification power is even less than that impn'ed by the tables.
To summarize the findings for the first hypothesis; scores on the
Vigilance Task and the Matching Faminar Figures Test do not yield
61
dlscrimlnant functions which accurately and consistently differentiate
hyperactive from non-^hyperactive children, The correct detections mea-
sure on the Vlgilance Task (and latency on the MFFT, but to ^ much les-
ser degree) show promise as having some discriminating abin'ties.
Hypothesis 2
The second hypothesis is stated in null form and proposes that
neither the Vigilance Task nor the Matching Familiar Figures Test
alone can accurately and consistently differentiate hyperactive from
non-hyperactive children. This hypothesis has been supported in these
findings, but by defauU.
Since a combination of the best discriminating scores from the
two tests^ does not yield accurate classification, nor do such classifi-
cations resuU when all scores combined are used in the discriminant
function, it follows that neither test alone can discriminate accurately.
The Vigilance Task is the better of the two, specificany due to the
apparent discriminating abinty of its correct detections score,. but
it does not approach the level of accuracy needed in such instruments.
The latency score on the MFFT also has some discriminating abin'ty,
but again, not enough to resuU in consistently accurate classifications.
Hypothesis 3
Hypothesis 3 deals with sex and age differences with regard to
the discriminant functions ability to classify hyperactive, learning
disabled, and normal children accurately. Separate discriminant ana-
lyses were performed on subsamples of the subjects, namely males, fe-
males, young, and old. If the discriminant analyses had yielded marked
62
improvements in classificgtipn accuracy this would have been reflected
in the percent of grouped cases accurately classified by the appn'cation
of the discriminant function. Since in the fun analysis the inclu'sion
of a n variables was slightly more discriminating than the stepwise
procedures, it is this former procedure which has been used to investi-
gate this hypothesis. Table 15 shows the percent of grouped cases cor-
rectly classified for the various subsamples.
Table 15
Results of Classification
For Various SubsampTes
PERCENT OF GROUPED CASES SUBSAMPLE CORRECTLY CLASSIFIED
Females 58.33%
Males 61.54%
Young 58.82%
01d 61.22%
It can be seen that the functions' discriminating abilities im-
proved slightly over the full sample in each of the four subsamples,
None of these differences, however, were substantial. There were no
subsamples which yielded discriminant functions that approached the
level of desirable discriminabin'ty for the purposes being investigated
here, that is, identifying hyperactive children from non-hyperactive
children,
Hypotheses 4 and 5
Hypotheses 4 and 5 propose that hyperactive chi ldren w i n obtain
63
measurably different scores on the Vigilance Task and the Meitching
Famin'air Figures Test from the rest of the sample, and that the scores
of normal subjects win be different as well. Table 16 contains the
means and standard deviations of each measure for the three groups of
subjects. It can be seen that hyperactive and learning disabled child-
ren tended to obtain very similar scores on all measures, while normals
tended to differ from the other two groups, particularly on correct
detections,
Table 16
Means and Standard Deviations for Scores on the Vigilance Task
And MFFT for Hyperactive, Learning Disabled, and Normal Groups
GROUPS MEASURE - HYPERACTIVE LNG. DISABLED NORMAL TOTAL
Correct Detections
Mean
S. D.
False Alarms
Mean
S, D.
Errors
Mean
S, D.
Latency
Mean
S. D.
45.74
14.09
8.63
16.83
13.44
9.99
11,38
6.45
44,33
12.55
8.33
13.64
13,85
7.81
\
12,20
6.40
54.54 44.41
6.91 11.75
3.26 6.08
8.24 12.69
11.59 12.70
5,50 6.61
11,02 11.44
5.40 5.93
64
An analysis of variance (see Table 17) shows that the groups are
significantly different with respect to their scores on correct detec-
tions, They are not, however, different with respect to the three
other scores (see Tables 18, 19, and 20).
Table 17
One-Way ANOVA ResuUs from
Three Groups on Correct Detections
SOURCE
Between Groups
Within Groups
^ SUM^OF SO.
2271.59
.11406.60
DF MEAN SO,
97
1135.80 9.7 .0001
117.59
R Eta
.3441
.4075 R^ = .1184
Eta Sq. = .1661
Table 18
One-Way ANOVA Results from
Three Groups on False Alarms
SOURCE
Between Groups
Within Groups
R = Eta =
SUM OF SO.
678,19
15259.17
-.1888 .2063
DF
2
,97
R2 = Eta Sq, =
MEAN SO.
339,01
157.31
.0356
.0426
F
2.16
P
.1214
65
Table.l9
One-^Way ANOVA ResuUs from
Three Groups on Latency
SOURCE
Between Groups
Within Groups
R = Eta =
^ SUM OF SO.
23.51
3460.32
-.0354 .0821
Table 20
DF
2
97
Eta
MEAN SQ.
11.76
35.67
R^ = .0013 Sq. = .0067
F
.33
/
P
.7201
OnervWay ANOVA ResuUs from
Three Groups on Errors
SOURCE
Between Groups
Within Groups
R = Eta =
^ SUM OF SO.
107.77
4221.23
-.1301 .1578
DF'
2
97
Eta Sq. =
MEAN SQ.
53.89
43.52
.0169 ,0249
Ll_
1.24
P
.294
A group of ;t-tests comparing scores of each group with the other
(see Table 21) confirms the assertion that normals obtain significantly
different correct detection scores from both hyperactive and learning
disabled children, Thus, hypotheses 4 and 5 can only be accepted in
part, Hyperactive children do obtain quantitatively different scores
from normals (but not different from learning disabled children) on the
correct detections measure (but not on the other measures), Normal
Table 21
" tr^Values and Probahin'ties for Scores
On the Vigilance Task and the MFFT
66
- , .
GROUPS COMPARED MEASURE
Hyper/LD
Correct Detections
False Alarms
Errors
Latency
Hyper/Normal
Correct Detections
False Alarms
Errors
Latency
LD/Normal
Correct Detections
False Alarms
Errors
Latency
;t-VALUE
.39
.07
-.20
-.47
-=3704
1.55
1.26
.25
-3.89
1.75
1.45-
.84
33
33
33
37
DF
52
52
52
52
.47
.44
71
71
.42
,34
71
71
2-TAILED PROB.
.700
.944
.841
.642
.005
.130
.213
.802
.001
.088
.152
.406
children do obtain quantitatively different scores from both hyperactives
and learning disabled children on correct detections, but not on the
other measures. With respect to these instruments hyperactive and learn-
ing disabled children. as a group, seem to be different (in terms of cor-
rect detection scores) than normals, but they apparently are not dif-
ferent from each other.
67
Hypothesis 6
If the scores on the Vigilance Task and the Matching Famin'ar
Figures Test reflect certain characteristics of cognitive experience
(e.g,, attention, impulsivity) one would expect that the respective
scores would be related to each other in appropriate directions. For
example, if false alarms on the Vigilance Task increase along with im-
pulsivity, that score would be expected to correlate negatively with
latency on the MFFT and correct detections on the Vigilance Task
(which both should increase with less impulsive subjects) and positively
with errors on the MFFT (which should increase with more impulsive sub-
jects), In short, as hyperactivity increases correct detections
should go down, false alarms should go up, latency should go up (be-
cause non-impulsive, non-hyperactive children will take their time to
insure a correct answer) and errors should go up. These expected inter-
correlation directions are summarized in Table 22. The actual inter-
correlations yielded by the data are presented in Table 23,
Table 22
Expected Intercorrelation Directions of
Vigilance Task and MFFT Scores
CORRECT FALSE ERRORS LATENCY DETECTIONS ALARMS
Correct Detections + - - +
False Alarms + +
Errors +
Latency +
68
Table 23
Intercorrelations and Probabin'ties Between
Scores on the Vigilance Task and the MFFT
Correct Detections
False Alarms
Errors
*p < .001 **p .05
CORRECT DETECTIONS
FALSE ALARMS
-.3328*
ERRORS
-.3394*
.3695*
LATENCY
.2015**
-.1612
.3153*
A n of the correlations are in the expected directions, with four out
of the six being significant at least to the .001 leven
The above data thus supports hypothesis 6 (at least in part).
The scores on the tests are moderately correlated in the expected direc-
tions, lending support to the notion that they are measuring similar,
or at least coexisting characteristics,
Hypothesis 7
This hypothesis was included as a resuU of the n'mited availa-
bin'ty of renabinty data on these two instruments. While test-retest
figures would have been more helpful, that kind of data was not obtained
due to the unavailabin'ty of an adequate number of subjects who could be
retested.
Pearson r correlation coefficients were computed for the split-
half resuUs of each test. In the case of the Vigilance Task, scores
during odd and even five-minute intervals were conected separately.
For the MFFT the items were divided evenly into odd and even numbered
items.
69
While correct detections on the Vigilance Task and latency on the
MFFT yielded reasonably high Pearson £'s (.8297 and .9262 respectively),
false aUrms (.7283) and particularly errors (.5447) fen short in terms
of spn't-haU reliabin'ties. It should be noted again that correct de-
tections and latency were found also to be the most powerful discrimi-
nators among the scores as wen. It is intuitively and statistically
reasonable that the less consistent measures would not be the most power-
ful discriminators.
Hypothesis 7, then, can only be supported in part. One score on
each test (correct detections on the Vigilance Task, latency on the MFFT)
demonstrates adequate splitr^half ren'abin'ties.
Hypothests 8
Hypothesis 8 is essentially concerned with two issues; (a) whether
or not parents and teachers report the same kinds of behaviors for the
same children, and (b) whether the reports of these behaviors are re-
lated to the scores that woúld be expected to resuU on the Vigilance
Task and the MFFT. The first issue is crucial to the entire study,
Teacher and parent reports were used to originany classify the sub-
jects into their respective groups. Concensus on the reports was re-
quired for the child to be placed in a group, That is, a n reporters
had to agree that the child exhibited the same kinds of behavior, If
these raters did not agree than the original classification scheme (at
least for the hyperactive group) would be suspect.
The intercorrelation matrix found in Table 24 demonstrates that
there was a considerable amount of agreement between all the raters on
all of the rating scales. Intercorrelation coefficients range from
Id
CsJ
cu
fO
to cn E
+-> fO
Dc:
c (U S-fT3
û -
•C3 c ro
s_
j r : o
cu
S-o
t f -
s-
«3
c p
+J fO
'ãj s_ s-o o s_ cu
co
<u S-o o
oo
CM
(U S-o o
(>0
• ) «
UD r o r H 0 0
• 0 0 CJ O cy>
* r^ 1—1
r o ( D
•K r o C>J 0 0 0 0
(U s-o o
oo
• ( D r o 0 0 CD
•K r>. r^ r^ UD
r^
c o cu s-o o
oo
o
•X OO co r«>. r^
• cr> r»> cri 00
• vo r^ LD
•K CM 0 0 «—) 0 0
•íc O
VD r^
0 0 LO
CU s-o o
LT)
* C\J 0 0 cri 0 0
• r>* CJ co 0 0
• » <
0 0 i n r>^ ( D
CvJ CM
s- s- s_ s-di <D (U (U S-
JZ .a JC ^ (U O O O O JZ fO fO '—^ fO fO •<-> (U (U S- (U (U o
f— h - (U I— I— ^
«4- i+_ 4-> M- M- q -o o o o o o (U (U S- S-
o o o o
<>o t>o
cn (/) S- S-(U (U C E E C O O o o
1 1 1 1
r-H C\J
QJ (U
s_ s-o o o o
(U s-
(U s-o o
O V) o
oo
s o . ^< : : 3
rxj
1
(U s-o o
1 — 1
1 — 1
1 — (
2 : LD Q
1 1
t—1
(U S-o o
(U S-o o
oo 1—(
»—í
1—t
5^ oo Q
1
CM
(U s-o o
(U s-o o
oo 1—1
1—1
1—1
2 1 oo Q
1 1
<>0
(U S-o o
OO OO t / ) (/) t/î t /)
O O rvl Q Q Q
cu S-o o
t>0
o
CVJ
CU S-o o
t/O
o
CU S-o o
co
r^
s-o o
t /)
co (U S-o o
oo
o o
•
71
,6317 to .9028. Not only were teachers and parents agreeing that hyper-
actives exhibited hyperactive behavior patterns, they also agreed that
non-hyperactives did not exhibit hyperactive behavior patterns. As
might be expected the lower correlations were generany those comparing
mothers' responses (Z Score, D Score 3) with those of teachers (C Score
1, C Score 2, D Score 1, D Score 2). Teachers tended to agree quite
markedly, A n correlations were significant beyond the .001 leveK
The second issue raised in hypothesis 8 involved whether the reports
of teachers and parents are related to the scores that would be expected
to resuU in the Vigilance Task and the MFFT. For example, as teacher
and parent rating scores go up (indicating more symptoms of hyperactivity)
one might expect correct detections to go down (hence, a negative corre-
lation). The expected directions of correlation are summarized in Table
25. Actual correlation figures can be found in Table 26.
Table 25
Expected Correlation Directions for
Test Measures and Teacher and Parent Ratings
CORRECT FALSE DETECTIONS ALARMS ERRORS LATENCY
C Score 1 - + + .
C Score 2 - + + -
Z Score - + + -
D Score 1 - + + -
D Score 2 - + + -
D Score 3 - ^ + -
Table 26
Obtained Correlation Coefficients for
Test Measure and Teacher and Parent Ratings
72
C Score 1
C Score 2
Z Score
D Score 1
D Score 2
D Score 3
CORRECT DETECTIONS
-.3572*
-.2947*
-.3255*
-.2967*
-.2704*
-.2375**
FALSE ALARMS
.2232**
.1714
.2526
.2246**
.2621*
.1905
ERRORS
.1290
.1712
.1643
.2010**
.2332**
.1396**
LATENCY
-.0235
.0010
-.0930
.0630
.0563
-.0895
*P < .01'
**p< .05
The correlations were generany in the expected directions, with
scores for correct detections being significantly correlated with tea-
cher and parent ratings. Again, thisis to be expected given the rela-
tive success of the correct detections score in identifying hyperactive
children.
It can be concluded that the data strongly supports the first is-
sue of the hypothesis, teachers and mothers do agree on their ratings of
the children in this study. Teachers and mothers are evidently seeing
and reporting the same kinds of behavior, behavior which is consistent
with a diagnosis of hyperactivity. The second issue in hypothesis 8
was also confirmed, aUhough not so definitively. Teacher and parent
ratings do tend to be related to scores on the Vigilance Task and the
MFFT in the expected directions. The correct detections score, in
73
particular, was significantly correlated with the ratings,
^ Hypothes^is 9
Hypothesis 9 deals with the relationship between scores on the
Vigilance Task and the MFFT and the subject's intein'gence. The Slosson
Intein'gence Test was administered to each subject along with the re-
search instruments, Descriptive data on subjects' lOs can be found in
Table 27.
Table 27
Descriptive Data Concerning Subjects' IQ
STATISTIC ALL SUBJECTS HYPERS. L.D.s NORMALS
Mean
Standard Deviation
103.940
14.955
101.111
15.126
97.296 109.500
11.296 14.941
It can be seen in Figure 1 that the IQ scores of this sample are
characterized by a reasonably normal distribution, aUhough sn'ghtly
skewed toward higher IQs, This skewness is largely due to the higher
than average IQs seen in the normals (a group which was made up of
students at a private elementary school),
Table 28 gives ;t-test data related to the differences in IQ
scores between the three groups, It can be seen that normal subjects
obtained significantly higher IQ scores than did learning disabled
children (t = ^3.67, p = .001), while the difference in IQs between
hyperactives and normals approached significance (;t = -2.31, p = ,024).
74
30 -
S
U
B
J
E
C
T
S
25
20 -
15 -
10 -
5 -
70-79 80-89 90-99 100-109 110-119 120-129 130+
IQ
Figure lir Distribution ofjTQ.Scores
The relationship between IQ scores and performance on the Vigi-
lance Task and the MFFT is summarized in Table 29. Intein'gence scores
were correlated significantly with correct detections and false alarms
for the fun sample. More intenigent subjects tended to have more
correct detections and fewer false alarms than less intenigent
Table 28
t -Tests Comparing IQ and Groups
75
GROUPS t-VALUE DF 2-TAILED PROB.
Hyper/LD
Hyper/Normal
Normal/LD
1.05
-2.31
-3.67
52
71
71
.299
.024
.001
Table 29
Correlation Between IQ and
Scores on the Vigilance Task and the MFFT
MEASURE
Correct Detections
False Alarms
Errors
Latency
ALL SUBJECTS
.28*
.33*
.14
.06
HYPERS.
.13
-.45**
_ 44**
-.00
L.D.s
.00
-.09
.16
-.12
NORMALS
.35*
-.28**
.00
-,02
* p ^ .01
**p< .05
subjects. This was particularly true with correct detections for the
normal group.
In response to hypothesis 9; there is some relationship between
subjects' Slosson 10 scores and performance on the Vigilance Task, par-
ticularly with normal subjects on correct detections. There are no sig
nificant relationships between subjects' IQ scores and either of the
76
scores on the MFFT. No relationships were found between hyperactives,*
scores on the tests and IQ scores.
CHAPTER IV
^ DISCUSSION
The primary purpose of this study was to investigate the effec-
tiveness of the Vigilance Task and the Matching Faminar Figures Test
for differentiating hyperactive children from non-hyperactive children.
Ostensibly these two instruments provide measures of attention and im-
pulsivity, two of the three major comoonents of Attention Deficit Dis-
order with hyperactivity. Previous research has shown the Vigilance
Task and the MFFT to be the most promising of the available objective
indices for tapping these characteristics in children. The objective
and accurate assessment of hyperactivity clearly becomes important when
diagnostic and treatment issues, as well as educational planning strate-
gies, are considered.
Nine hypotheses were tested in this study. The first two hypothe-
ses deaU with the two tests' abin'ty, when combined or taken alone, to
accurately and consistently differentiate hyperactive from non-hyperac-
tive (learning disabled and normal) children. The third hypothesis
investigated sex and/or age differences with regard to the discrimi-
nant functions' abin'ty to classify hyperactive, learning disabled, and
normal children. Hypotheses 4 and 5 involved whether or not hyperac-
tives and normals obtain measurably different scores on the instruments
than do the other groups, i.e., do hyperactives score differently on any
single measure than do normals and learninq disabled children, and do
normals score differently than hyperactives and learning disabled
children. Hypothesis 6 deaU with the question of whether the two
tests seem to be measuring the same and/or coexisting behavioral
77
78
phenomena. SpnU-haU ren'abilities were assessed in hypothesis 7,
The eighth hypothesis assessed whether or not the initial raters of the
children Cteachers and mothers) were agreeing as to the types of be-
havior they reported, Finany, hypothesis 9 looked at any relationships
which existed between the subjects' IQ and performances on the Vigi-
lance Task and the MFFT, The findings for each of these hypotheses
are discussed below.
Hypothesis 1
The hypothesis that scores on the Vigilance Task and the Matching
Familiar Figures Test can yield discriminant functions which accurately
and consistently differentiate hyperactive from non-rhyperactive children
was not supported, The most discriminating of the discriminant func-
tions yielded in this study (i.e., the function which took into account
a n four variables) accurately classified only 56% of the original
sample. It must be remembered that even this relatively low figure is
statistically inflated. The tests did most poorly when classifying
hyperactive children. Only one of the 27 hyperactive subjects was cor-
rectly placed in the hyperactive group.
Stepwise selection of variables revealed that correct detections
on the Vigilance Task was the most discriminating variable. Latency on
the MFFT improved discriminabin'ty by a small amount, The contribution
of the false alarm score on the Vigilance Task and the errors score on
the MFFT was negligible.
This data may support recent findings (Douglas, 1972; Dykman et
a n , 1971) which reveal an attentional deficit component as primary in
hyperactive children. IntuitiveTy it is reasonable to propose that
79
attentional deficits are reflected most in the correct detections mea-
sure of the Vigilance Task. Correct detections presumably drop as
children become less attentive to the stimun'. It may also be true-
however, that motoricany restless children (a characteri$tic of ADD
which was not assessed in this study) receive lowered correct detec-
tion scores because they are too busy being active to attend. It is
difficuU to separate out the concomitant effects of attention deficit
and restlessness. While the latency score on the MFFT (which also had
some discriminating abin'ties) obviously reflects some degree of impul-
sivity, it may also be a measure of attention. It is conceivable that
children with attentional deficits choose items on the MFFT yery quickly
simply because they are unable to attend long enough to peruse the items
more carefuny,
The impulsivity component of ADD is another matter. The data in
this study indicate that either these instruments are unsuccessful in
tapping the presence of impulsiveness in hyperactive children, or the
impulsiveness that is measured by these instruments is not a major com-
ponent of the hyperactivity seen by these teachers and mothers. It is
assumed that hyperactive children will generate significantly more false
alarms on the Vigilance Task than will non-hyperactive children, and
that the former group win make more errors on the MFFT as a result of
their rapid responding. Neither of these phenomenon was observed. It
is \/ery possible that the Vigilance Task and the MFFT simply do not pro-
vide van'd measures of relative impulsivity in children, The impulsiv-
ity probably exists in hyperactives. Teachers and mothers certainly
report that those children identified as hyperactive demonstrate more
80
Impulsive behaviors than do those identified as non-hyperactive, If
the impulsivity exists these instruments are apparently not measuring it
(unless elements of impulsivity are tapped in the correct detections
measure),
The four measures used in this study account for about 20% of the
variance in the discriminant function explained by the groups. This
is determined by squaring the canonical correlation (.45) yielded by
the most successful discriminant function. At least one of the scores
does seem to reveal (at least intuitively) some attention deficit com-
ponent as a primary factor in the differences between these groups. It
is not at a n clear, however, that this difference is confined to the
hyperactive group apart from the non-hyperactive group, In fact, normal
subjects were found to obtain significantly different scores on correct
detections than both hyperactive and learning disabled children, The
scores for hyperactives and learning disabled children were not signi-
ficantly different from each other, Hence, even correct detections
failed to discriminate hetween hyperactives and the learning disabled,
aUhough it did discriminate normal from non-normal children to some
degree. The usefulness of this \fery gross discriminating ability is
questionable.
- In short, this discriminant analysis provided no evidence that a
combination of the Vigilance Task and the MFFT scores can serve to ac-
curately classify children into hyperactive and non-hyperactive groups.
There is evidence that the correct detections measure of the Vigilance
Task does have some discriminating abin'ty in terms of the larger group
of hyperactive and learning disabled children combined. It is presumed
81
that this score reflects the presence of some attentional deficit
which meiy he common to hyperactive and learning disabled children in
general.
Hypothesis 2
Hypothesis 2 was confirmed; neither the Vigilance Task nor the
MFFT alone was successful in accurately and consistently differenti-
ating hyperactive from non-hyperactive children. It should be noted,
however, that the Vigilance Task alone would almost do as wen as a
combination of the tests.
The Vigilance Task does seem to have promise in playing a part
in the development of instruments used to diagnose hyperactivity. It
does have some degree of abin'ty to discriminate normals from non-
normals. Kagan's MFFT, however, showed n'ttle evidence of possessing
any discriminating power. Kagan proposed that impulsive children
(hyperactives are, by definition, impulsive) win tend to score lower
on Tatency and higher on errors than win non-impulsive children.
This was not found to be the case in this study. No significant dif-
ferences were found between hyperactives, normals, and learning dis-
abled children on either of the MFFT scores. In defense of Kagan, it
may well he the case that the non-hyperactive subjects were somewhat
impulsive, thus masking the differences between the groups. Also,
Kagan suggests dichotomizing subjects based on the scores, with impul-
sives being identified as those children who respond more quickly and
with more errors than the norm. When this was done with the current
sample 27 "impul sives^' were identified. Of this group seven were
rated as hyperactive, five were learning disabled, and 15 were in the
82
normal group. Hence, even when used gs suggested by its author the
instrument has poor discriminating abiU'ties.
Given the complexity and înuUipn'city of symptôms it is unU.kely
that any one or two instruments will successfully tap enough components
of ADD to enable accurate classification. Emphasis on attentional com-
ponents of the disorder does seem to be in order.
Hypothesis 3
Hypothesis 3 was accepted. There was no evidence of any sex or
age differences with regard to the discriminant function's abin'ty to
classify hyperactive, learning disabled, and normal children accurately.
It classified all sub-^^samples poorly. While the numbers of correctly
classified cases did go up somewhat when the samples were made more
homogenous with respect to age and sex, the accuracy of classification
was stin around 60%. Most of the cases correctly classified were in
the normal group. The rise in correct classifications could simply be
a reflection of the reduced sample size in each sub-sample.
The most accurate classification was seen in the males only group.
Since the incidence of hyperactivity in the population is generany
higher in males it is possible that this group consisted of proportion-
ally more "true" hyperactives as opposed to the "described" hyperac-
tives, hence, a rise in the function's ability to discriminate. It
could also be true, however, that males as a group typicany score in
the "hyperactive" directions on these tests more so than females.
Whatever the case, the discriminant function did not work signi-
ficantly better when appn'ed to only a particular sex or age group.
There may be some sex and/or age difference in the scores on these two
83
instrumentsj these differences, however, are not reflected by signifi-
cant increases in the discrimination power of the functions.
Hypotheses 4 and 5
Hypotheses 4 and 5 could be accepted, but only 1n part. Normals
did seem to score differently than hyperactive and learning disabled
children, but only with respect to the correct detections measure.
Scores on each of the other measures were not significantly different
from any of the other groups.
It is assumed throughout this discussion that the correct detec-
tions measure primarily te ps some attentional component of behavior.
If this is the case normal children have significantly better attending
abilities .than do hyperactive and learning disabled children. It would
also follow that the attending skins of hyperactive and learning dis-
abled children are not significantly distinct from each other.
AUernatively, the correct detections measure could be tapping
some cognitive and/or perceptual phenomenon, apart from attentional
deficits, that is common to hyperactive and learning disabled children,
but not present in normal children. For example, the response time
of normals in a vigilance paradigm may be significantly better than that
of the other two groups. Correct detections would increase if a sub-
ject required more than two seconds, in this case, to respond. In
effect he/she would then be responding to the wrong stimulus. Hyperac-
tive and learning di$abled children mgy be, as a group, more restless
than normals and hence have a greater chance of "missing" correct re-
sponses. Only further investigation will rule out these and other
possibin'ties,
84
In nght of all of the other findings the resolution of these
hypotheses is not surprising, If the performances of the various
groups had been more different from each other one would expect that
the power of the discriminant function would have been greater. Since
the discriminant function demonstrated limited discriminating ability,
with the correct detections measure providing most of the discrimi-
nation, it follows that the performance on the other measures would have
evidenced little variabin'ty between groups. This, indeed, was the
case. Future researchers would probably be wise to not consider false
alarms in a vigilance paradigm, and errors on the MFFT as potential
discriminating variables for classifying hyperactive children.
Hypothesis 6
Hypothesis 6 deals primarily with the issue of concurrent van'dity
of the instruments. If it is assumed that the Vigilance Task and the
MFFT are measuring similar or coexisting characteristics one would ex-
pect their scores to yield correlations in the appropriate directions.
The stronger the relationship the more n'kelihood there is that the
measures are tapping the same or coexistent phenomenon.
This hypothesis was supported in part. A n corre.lations were in
the appropriate directions and four out of the six were significant at
the .01 level (see Table 17). The degree of correlation, however, was
modest, ranging (in absolute terms) from .1612 (p = .055) to .3695
Cp = .001).
The measures do seem to be tapping some of the same phenomenon.
Subjects who score in one way on one of the measures do tend to score in
the "correct" theoretical directions on the other measures. For example.
85
if a sutgect is relatively high in correct detections, he/she will
nkely be low on false alarms and errors, and high on latency,
The highest correlation was found between false alarms on the
VigHance Task and errors on the MFFT. If a subject is golng to give
a "wrong" response chances are it will be given on both tests. Cor-
rect detections and false alarms were also significantly related (in
the negative directions). This would not have been the case if most
of the subjects had been either over-responders or under-responders.
For over-responders (those who push the button excessively and indi-
scriminantly) false alarms and correct detections would have risen coh-
currently, they would have dropped concurrently for under-responders,
Subjects_in this study viere apparently somewhat selective in their re-
sponse strategies, While this data was not available in the present
study, it would be interesting to investigate whether or not there are
differences between over- and under-responders on the Vigilance Task.
Correct detections yielded a significant negative correlation
with errors on the MFFT (-.3394, p = .001). It is intuitively reason-
able that this may reflect either some attentional or intenigence fac-
tor. Attentive and/or intenigent children would n'kely do better on
both correct detection and error rates. The correlation of Slosson IQ
with correct detections was, in fact, ,2808, which is significant at
the .002 level. 'Errors on the MFFT and IQ correlated -.1412 (p ^ .081),
a figure which approaches significance,
Finany, errors and latency on the MFFT were significantly corre-
lated (-.3153, p = .001). This relationship. of course, is to be ex-
pected, if only from a theoretical perspective. Children who take more
86
time to inspect the stimulus are nke ly to make fewer errors.
Hypothesis 7
Hypothesis 7 deals with spn't-haU ren'ability data for the two
instruments. The vandity of psychometric instruments is, of course,
n'mtted by their degree of reliabinUy, While test-retest and/or aUer-
nate form data would have been more instructive the means for obtaining
such data were not available. Scores were recorded for each measure,
however, in spn't-haU forms, yielding a rough measure of each instru-
ment's internal consistency.
Correlation coefficients actually give the reliability of only a
haU-test, Other things being equal, the longer a test, the more re-
liable it'Win be, The éffect that lengthening or shortening a test
will have on its correlation coefficient can be estimated by means of
the Spearman-Brown formula (Anastasi, 1976). When this is appn'ed to
split-haU correlation coefficients of the measures of interest it re-
suUs in ren'ability figures of ,91 for split-halves of the Vigilance
Task, and .84 for spn't halves of the MFFT.
Thus it can be said that the two instruments demonstrated adequate
split-haU reU'abin'ty figures, particularly in the case of the Vigi-
lance Task. This is statisticany reasonable because the Vigilance
Task encompasses considerably more discrete items than does the MFFT.
Longer forms of the MFFT would certainly prove to be more ren'able.
Hypothesis 8
Both elements of hypothesis 8, dean'ng with the teacher and parent
ratings, were confirmed. These ratings were used to initiany classify
87
children into the hyperactive and normal groups, and also served, in
some cases, to exclude children from particular groups. Four of the
five ratings must have met the criteria for hyperactivity in order for
a particular subject to be included in the hyperactive group. If more
than two ratings (but less than five) reported hyperactive behavior the
child was not included in the study at a n . Learning disabled children
(as defined by Texas Education Agency standards) who were also reported
to be hyperactive (and satisfied the criteria for hyperactivity)
were placed in the hyperactive group. Normal children could have no
more than one "hyperactive" rating. Stringent criteria such as these
were used in order to insure that only hyperactive children were in-
cluded in the hyperactive group and that no hyperactive children were
included in the other groups,
In light of the above it is important that there be a large de-
gree of inter-rater ren'ability present in the ratings. Table 24 re-
ports these figures.. As might be expected teachers tended to agree more
with themselves and with other teachers than they did with mothers in
terms of their ratings. A n of the correlation coefficients, however,
were significant beyond the .001 level, ranging from a low of ,6317 to
a high of .9028.
Parents and teachers were apparently seeing and reporting the
same types of behavior (or absence of behavior) in the same children.
When one teacher rated a child as hyperactive, so did other teachers and
the child's mother (by definition in the current study), A n tended to
be in agreement when no hyperactivity was noted. While a n children
in the hyperactive group met the minimum (though stin stringent)
88
criteria for being classified hyperactive, some of the variance found
in the ratings is a resuU of raters endorsing more items than were
required to meet criterion levels. Hence, if anything, the inter-
rater reU'abinty coefficients reported are sn'ghtly deceiving on the
conservative side. Teachers and parents were definitely agreeing
on the behaviors that they reported. It can thus be reasonably assumed
that these children identified in this study as being hyperactive do,
indeed, exhibit hyperactive symptoms both at home and at school.
The second element of this hypothesis involved the relationship
between the ratings and scores on the two research instruments. This
is essentiany another van'dity issue. If the tests do measure traits.
that are related to hyperactive behavior (.e.g., attentional deficits,
impulsivity) one would expect scores which measure these traits to be
related to ratings based on behavioral observations. This was found to
be the case with the correct detections measure but not with false
alarms, errors, or-latency. As correct detections increased mother and
teacher reports of hyperactive behaviors went down. Generany these
other scores were in the direction that would be expected but only
correct detection scores reached significance.
These data provide further evidence that the correct detections
measure is tapping some component of hyperactivity. This also lends
support to the data which indicates that the other measures do not
necessarily reflect hyperactive behavior patterns.
To summarize, mothers and teachers are seeing and reporting the
same types of behavior in these children, behavior which is consistent
with a hyperactive classification. These ratings are significantly
89
correlated, at the ,01 leveU with correct detection scores on the Vigi-
lance Task but not with false alarms on the Vigilance Task and errors
on the MFFT,
Hypothesis 9
Hypothesis 9 states that there will be no relationship between
subjects' Slosson IQ scores and performance on the Vigilance Task and
the MFFT. This hypothesis could only be supported in part,
When a n subjects were taken into account there were significant
correlations between IQ and both measures on the Vigilance Task, IQ
and correct detections correlated .28 (p = .005).while IQ and false
alarms correlated -.33 (.p = .001). When the groups were considered
separately only IQ and correct detections correlated significantly
for normal subjects (r = .35, p = ,009). Neither of the measures on
the MFFT had a significant relationship with IQ.
Langsdorf (1980) found that intelligence did differentiate hyper-
active from non-hyperactive children. While significant differences
were not found in this study the trend was certainly in that direc-
tion (;t hyper/normal = -2.31, p = .024, df = 71). There was a signi-
ficant difference in intelligence between learning disabled and normal
children (;t normal/LD = -3,67, p = .001, df = 71). The use of a more
sophisticated measure of intelligence may contribute significantly to
the discriminating ability of the correct detections measure. The
unique contribution of IQ, however, may be small due to the relationship
between IQ and correct detection scores.
90
Implications
It is apparent that the Vigilance Task and the MFFT scores do
not differentiate hyperactive from non^hyperactive children. The most
accurate discriminant function resulted in about 55% of the sample be-
ing correctly classified (and that figure itself is statistically in^
flated), More conventional diagnostic procedures (rating forms, be-
havioral observations, interviews) probably result in comparable, if
not better, hit rates. In short, a combination of these two instru-
ments does not provide the hoped for objective indicant of Attention
Deficit Disorder symptoms.
The measures do, however, (specifically correct detections) tend
to differentiate the larger group of learning disabled plus hyper-
active children from the "normal" group. This larger group may, in
fact, be identified as a generic learning disabled group composed of
children who have some specific developmental learning disorder (e,g,,
developmental reading disorder, developmental language disorder) and
children who could be diagnosed as having an Attention Deficit Disorder
with Hyperactivity, In this study members of the latter group could
also meet the criteria for inclusion in the former group were it not for
their hyperactivity. In fact, 20 subjects in the hyperactive group
had also been diagnosed learning disabled. Of the seven remaining four
were below the age of eigíit and may simply have yet to be identified as
learning disabled. While the numbers were too small to analyze in the
present study it is likely that a "hyoeractive only" group would have
been more distinct from the others.
The learning disabled and hyperactive children in this study are
91
evidently similar with regard to the presence of an attentlon deficit
(assuming that correct detections taps attention deficits), The iíTipul-
sivlty dimension is less clear. It may be that "hyperactive only"
children would be more distinct with respect to impulsivity and motoric
restlessness. Children who are identified by parents and teachers as
displaying hyperactive behavior (at least in this group of subjects)
also meet the criteria for being identified as learning disabled.
This learning disability confound may be masking the differences be-
tween the groups. Future studies should make this distinction more
carefully,
The Vigilance Task, specifically its correct detections score, is
somewhat effective in differentiating the larger group of learning dis-
abled and hyperactive children from normals. This confirms the data
reported by Anderson and his colleagues (1973), Several different
sets of findings in this study suggest that correct detections does
have some validity in terms of its ability to tap some component of
Attention Deficit Disorder with Hyperactivity.
The MFFT was almost wholly unsucessful at discriminating between
hyperactive and non-hyperactive children, It added yery little to the
discriminating power of the Vigilance Task. From the data collected
in the present study one has trouble seeing any important relationships
between scores on the MFFT and the presence of hyperactive behavior
patterns.
It is probably overly optimistic to expect a small number of ob-
jective instruments to tap the multiplicity of behavioral, cognitive,
and emotional manifestations of Attention Deficit Disorder with
92
Hyperactivity, Correct diagnoses should, nevertheless, be a high pri-
ority due to the implications of diagnostic errors. Clearly these two
instruments alone are not adequate. The Vigilance Task (or something
similar), however, shows promise of having some discriminating ability
and appears to have some validity with respect to measuring some of
the components of hyperactivity,
Directions for Future Research
This study has demonstrated that at least one objective measure
(correct detections on the Vigilance Task) has some significant rela-
tionship to the presence of hyperactive behavior patterns. The measure
presumably taps the attentional deficit component of ADD with hyperac-
tivity, Alternative vigilance paradigms and/or other measures aimed
at detecting differences in attending abilities may prove useful in
improving the discriminative ability noted in the Vigilance Task.
Future investigators should probably utilize some relatively sophisti-
cated measure of intellectual functioning as part of the test battery.
Some relationships were noted in the present study with regard to in-
telligence and correct detections.
The MFFT in its present form, has not proven to contribute signi-
ficantly to a discrimination of hyperactives from non^hyperactives.
It is possible that a more refined, longer version of the MFFT, or some
similar instrument, may prove useful in yielding data about the impul-
sivity dimension of ADD, False alarms on the Vigilance Task, also pre-
viously thought to be related to impulsivity, yielded disappointing
results as well.
The third dimension of ADD is hyperactivity or motoric restlessness.
93
Several attempts have beeh made to operationalize measures of activity
with little success, These measures tend to be impractical in terms of
economics, degree of intrusiveness, reliability, etc, Nevertheless,
an agreed upon standard for measuring lîiotoric restlessness would be
very helpful in developing objective diagnostic procedures, A chair
fitted with mercury switches has been used with the Vigilance Task
in the past, providing an activity count measure along with correct
detections and false alarms. This particular measure, however, becomes
less reliable as activity increases; hyperactive children have a ten-
dency to get out of the chair. One possible alternative (in areas
where the equipment can be permanently installed) is to have the entire
floor wired for movement,
In conclusion, it is felt that the further refinements of mea-
suring devices used to tap the three components (inattention, impulsi-' '
vity, and hyperactivity) of ADD may lead to more reliable and objective
classifiers of hyperkinetic children, This is seen as a desirable
goal in light of the implications of faulty diagnoses, The present
study demonstrates that two such instruments currently available are
inadequate for this purpose when taken alone, or when combined by dis-
criminant analysis procedures, This study did indicate, however, that
one measure on the VigiUnce Task, correct detections, may prove useful
as part of a larger battery.
Limitations
The subject population of this study was obviously not a repre-
sentative sample of five- to eleven-year-olds. The "normal" grouo,
in particular, probably possessed characteristics which were quite
94
different from what would b,e found in a randomly chosen sample, The
fact that they were students in a church^supported private school im-
plies that they would be distinct from public school children in several
ways, As a group their IQ scores were higher than the children in the
other two groups, This is not surprising since the other groups were
comprised of children who, by definition, have had difficulties in school,
It might have been helpful, though, to account for IQ differences in
the three groups, either by partialling out its effect or by including
the IQ measure as one of the discriminating variables. The latter ap-
proach would have been niost appropriate considering Langsdorf's (1980)
finding that there is a relationship between IQ and levels of hyperac-
tivity.
This very issue could be seen, however, as a plus for this study.
As it was, the "normal" group was more distinct from the hyperactive
group than would have been the case otherwise. That is, the normal
group constituted children who were certainly not hyperactive and not
learning disabled. These children are typically self-selected out of
private schools, If the tests had discriminating abilities they should
have certainly been able to discriminate between these two very dis-
tinct groups,
The hyperactive'and learning disabled groups were not totally
representative either, In an effort to avoid confounds resulting from
the increased attribution of hyperkinetic behavior to minority children,
this sample was limited to Caucasion elementary school students. It
would have been interesting to investigate racial and/or cultural dif-
ferences with respect to performance on these two instruments. Also
95
excluded were students who were being medically treated for hyperac-
tivity, The inclusion of these children would have added an additonal
dimension and focus to the study,
The inclusion of some measure of activity level as a discrimi-
nating variable might have served to increase the power of the discrimi-
nant function. A stabilimetric cushion which was available was not used
due to the unreliability of its measurement, The addition, though, of
a valid measure of motoric restlessness might have contributed sub-
stantially to the classifying ability of the function.
Even though the Vigilance Task showed some promise in tapping
components of ADD it is doubtful that it could ever be used as part of
a standa^rd battery, The instrument, in its current design, is simply
too bulky, obtrusive, and cost-ineffective to be useful in most applied
settings, Its continued use as a research tool, however, is certainly
in order,
CHAPTER V
SUMMARY AND CONCLUSIONS
This study investigated the feasibility of using scores on the
Vigilance Task and the Matching Familiar Figures Test in a discriminant
function in order to differentiate hyperactive from non-hyperactive
children, A review of the literature pointed to these two instruments
as being potentially the most useful in assessing the inattention and
impulsivity components of ADD with hyperactivity. There were no ade-
quate instruments extant to tap the hyperactivity dimension. It was
proposed that these two instruments might serve as a base for a battery
of tests aimed at providing objective and reliable diagnoses of hyper-
active children, The importance of accurate diagnoses was discussed in
light of the typical treatments (specifically pharmacological ones) and
their often deleterious side^ffects.
Nine hypotheses derived directly from the basic issue of the dis-
criminability of these tests. One hundred children, their teachers,
and their mothers participated in this study. The design involved two
stages (a) the assignment of each subject to the appropriate group.
i.e., normal , learning disabled, hyperactive, and (b) the assessment
stage at which time the predictor, or discriminating variables were
administered.
Children were assigned to their respective groups on the basis
of rating forms filled out by mothers and teachers. Rigid, multiple
criteria were utilized for inclusion in the hyperactive group. The
discriminating variables used were the correct detections and false
alarm scores on the Vigilance Task, and the latency and errors scores
96
97
on the MFFT,
Data were analyzed using full and stepwise discriminant analyes.
The conclusions of this study were as follows:
1. Scores on the Vigilance Task and the Matching Familiar Figures
Test do not yield discriminant functions which accurately and
consistently differentiate hyperactive from non^hyperactive
children. Correct detections on the Vigilance Task was the
only measure demonstrating marked discriminating power.
2. Neither the Vigilance Task nor the MFFT alone can accurately
and consistently differentiate hyperactive from non-hyperactive
children,
3. There was some relationship between subjects' Slosson IQ and
• performance on the Vigilance Task (particularly correct de-
tections), There was no relationship between Slosson 10 and
MFFT performance.
4. Normal children obtained quantitatively different scores on
correct detections on the Vigilance Task than learning dis-
abled and hyperactive children. There were no significantly
different scores between the groups on the MFFT.
5. Scores' on the Vigilance Task and the MFFT were, in general,
significantly correlated (in the appropriate d.irections).
They are apparently measuring some similar and/or coexisting
phenomenon.
6. Adequate s p l i t - h a l f r e l i a b i l i t i e s were noted in both ins t ru -
ments, pa r t i cu la r l y the Vigilance Task.
7. Teacher and parent ratings were correlated highly with each
98
other indicating that teachers and parents were reporting the
same behaviors in the same children, These ratings were also
somewhat correlated with scores on the Vigilance Task and the
MFFT in the expected directions,
8. There were no significant sex or age differences with regard
to the discriminant functions' ability to classify hyperac-
tive, learning disabled, and normal children accurately,
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APPENDICES
A. DIAGNOSTIC CRITERIA FOR ATTENTION DEFICIT DISORDER WITH HYPER-
ACTIVITY.
B, PARENT COVER LETTER (ST. JOSEPH'S).
C PARENT COVER LETTER (LEVELLAND).
D, INFORMED CONSENT FORM.
E, ZUKOW HYPERKINESIS RATING FORM.
F, BEHAVIOR CHECKLIST,
G, CONNER'S ABBREVIATED TEACHER RATING SCALE,
H, TEST REPORT FORM.
I. TEXAS'EDUCATION AGENCY GUIDELINES FOR IDENTIFYING LEARNING DISABLED
STUDENTS,
J, VIGILANCE TASK BOOTH.
K. AUDIQTAPE RECORDED INSTRUCTIQNS.
L. DISSERTATION RECORD SHEET.
118
119
APPENDIX A; DIAGNOSTIC CRITERIA FOR
ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY
The child dispUys, for his or her mental and chronologicsil age,
signs of developmentally inappropriate inattention, impulsivity, and hy-
peractivity, The signs must be reported by adults in the child's environ-
ment, such as parents and teachers. Because the symptoms are typically
variable, they ma y not be ohserved directly by the clinician. When the
reports of teachers and parents conflict, primary consideration would
be given to the teacher reports because of greater familiarity with age-
appropriate norms. Symptoms typically worsen in situations that require
self-appltcation, as in the classroom, Signs of the disorder may be ab-
sent when the child is in a new or a one-to-one situation.
The number of symptoms specified is for children between the ages
of eight and ten, the peak age range for referral. In younger children,
more severe forms of the symptoms and a greater number of symptoms are
usually present, The opposit'e is true of older children,
A. Inattention. At least three of the following;
(1) often fails to finish things he or she starts.
(2) often doesn't seem to listen.
(3) easily distracted,
(.4) has difficulty concentrating on school work or other tasks re-
quiring Sustained attention,
C5) has difficulty sticking to a play actiyity.
B, Impulsivity. At least three of the following;
(1) often acts before thinking,
(2) shifts excessiyely from one activity to another.
120
(3) has d i f f i c u U y organizing work ( th is not being due tp cpgni-
t i v e impairment),
(4) needs a l o t of supervision.
(5) f requent ly ca l l s out in class.
(6) has d i f f i c u l t y awaiting turn in games or group s i tuat ions,
C, Hyperact iv i ty . At least two of the fo l lowing:
(1) runs about or climbLS excessively.
(2) has d i f f i c u l t y s i t t i n g s t i l l or f idgets excessiyely,
(3) has d i f f i c u l t y staying seated.
(4) moves about excessively during sleep.
(5) i s always "on the go" or acts as i f "driven by a motor".
D, Onset before the age of seven.
E, Duration of at least six tnonths,
F, Not due to Schizophrenia, Af fect ive Disorder, or Severe or Profound
Mental Retardation,
American Psychiatr ic Association, Diagnostic and s t a t i s t i c a l manual
o f mental disorders (3rd Ed,), Washington, D, C ; American Psy-
ch ia t r i c Associat ion, 1980, 43-44,
121
APPENDIX B; PARENT COVER LETTER (ST, JOSEPH'S)
Parents,
The purpose of this letter is to ask your assistance with a re -search project which I am currently involved in. I would appreciate it n you would take a bit of your time to read this letter and consider allowing your child to participate,
The purpose of my project is to develop a group of tests which will accurately identify hyperactive children. I do need to test, however, a large group of non-hyperactive children as well. Your participation in the study will involve filling out a couple of short rating forms and a form of consent which wlll allow me to test your child.
The twotests that I v'ill be ginving are the following; 1. The Vigilance Task. This test ineasures attention span, impulsive-ness, and restlessness. It involves the child sitting at a console, watching lights flash on and off, and pushing a button occasionally. The test takes about 35 minutes to complete. 2, The Matching Familiar Figures Test, This test is also aimed at mea-suring impulsiveness. It only.takes about 10 minutes and involves your child simply pointing to a line drawing which is supposed to match another drawing, Further, I will aTso administer a very brief (.10 to 15 minute) test of intellectual functioning, I will be asking some of your child's tea-chers to fill out rating forms similar to the one you will complete,
I can assure you that the results of these tests will be confiden-tial and no one besides myself will have access to the records, I can also assure you that there is no possibility of these results being used to the detriment of your child,
The tests will be administered at St. Joseph's School during regu-lar school time (your child will miss about one hour of classroom time), I have attached a consent form which you should sign and send back to school if you agree to participate,
I would greatly appreciate your help with this project, If there are any questions you can contact me at home (797-1785). Thank you for your time and consideraticn of this matter.
John C, Simoneaux Doctoral Student - Texas Tech
122
APPENDIX C; PARENT COVER LETTER (LEVELLAND)
Parents,
.P. J h n'^^^^f í^ l^l^ letter is to ask your assistance .with a re-U if i '^^''L''Í^F^ ^ " currently involved in. I would appreciate H L Iif^''^"^'^ ^^^î.^ ^^^ °^ yo"^ ti" e to read this letter and consi-der allowing your chnd to participate.
.r..^^t ?"'"P°^^.? ^y P'-oject is to develop a group of tests which will accurately identify hyperactive children. I do need to test, however, a large group of non-hyperactive children as well, Your participation in the study will involve filling out a couple of short rating forms and a torm of consent which will allow me to test your child,
The two tests that I will be giving are the following; 1. The Vigilance Task. This test measures attention span, impulsiveness, and restlessness. Involves the child sitting at a console, watching nghts flash on and off, and pushing a button occasionally. The test takes a'bout 35 minutes to complete, 2. Matching Familiar Firures Test. This test is also aimed at measuring impulsiveness. It only takes about 10 minutes and involves your child simply pointing to a line drawing which is supposed to match another drawing, ' Further, I will also administer a very brief (10 to 15 minutes) test of intellectual functioning. I will be asking some of your child's tea-chers to fill out rating forms similar to the one you will complete.
I can assure you that the results of these tests will be confiden-tial and no one besides myself will have access to the records. I can also assure you that there is no possibility of these results being used to the detriment of your child.
The tests will be administered at the South Plains Educational Co-op building at a time which 'vill be arranged later. I have attached a consent form which you should sign and send back to school if you agree to participate.
I would greatly appreciate your help with this project, If there are any questions you can contact me at the co-op (894-6858). Thank you for your time and consideration of this matter.
John C Simoneaux Doctoral Student - Texas Tech
123
APPENDIX D: INFORMED CONSENT FORM
I hereby give my consent and agree to allow my child to participate
in the research project entitled "An Evaluation of the Classification
of Hyperkinetic Children with the Vigilance Task and the Matching Fa-
miliar Figures Test."
I understand that the person responsible for this project is John
C Simoneaux, Doctoral student, under the supervision of Dr. Robert P.
Anderson, Department of Psychology, 742-3736.
The objectives of this study have been explained; to evaluate the
usefulness of the Vigilance Task and the Matching Familiar Figures Test
in identifying hyperactive children.
I understand that the procedure involves my child being administered
the two tests mentioned above. The nature of these tests has been ex-
plained to me, I also understand that my child's teachers and myself
will be asked to complete a behavior rating form concerning my child,
This procedure has been judged to provide no discomfort or risks to
the subjects who participate,
Mr, Simoneaux has agreed to answer any inquiries I may have concerning
the procedures, I have haen informed that I may contact the Texas Tech
University Institutional Peview Board for the Protection of Human Sub-
jects by writing them in care of the Office of Research Services, Texas
Tech University, Lubbock, Texas 79409, or by calling 742-3884,
The following must app3ar on all consent forms:
"If this research project causes any physical injury to you ( our
child), treatment is not necessarily available at Texas Tech University
or any program pf insurance applicable to the institution and its
124
personnel, Financial compensation for any such injury must be pro-
vided through your own insurance program, Further information about
these matters may he ohtained from D, J, Knox Jones, Jr,, Vice Presi-
dent fpr Research and Graduate Studies, Room 118, Administration
Buildtng, Texas Tech University, Lubbock, Texas 79409, telephone
742-2152.
I understand that my child m^y not derive therapeutic benefit from
participation in this study, I also understand that my child may dis-
continue this study at any time I (or my child) choose.
Signeiture of Parent Date
Signature of Project Director^_ Date
125
APPENDIX E; ZUKOW HYPERKINESIS RATING FORM
Instructions? Circle the answer which best fits your child^s day-to-day behavior.
School
Sometimes
1, Usually hyperactive: Home
2, Jumps from one activity to another;
3, Short attention span;
4, Fidgets:
5, Is unpredictable, unmanageable;
6, Irritable;
7, Overly sensitive;
8, Quick tempered, explosiye: 1
9, Panics easily:
10, Tolerance for failure and frustration low:
11, Emotionally high strung;
12, Told ahead of time about an outing or appointment becomes anxious or upset;
13, Exceptionally clumsy:
14, Poor coordination:
15, Eyes and hands don't seem to function together;
16, Has trouble buttoning;
17, Has trouble drawing, writing;
18, Was slow learning to \;alk;
19, Trouble with bicycles:
20, Troúble catching balls;
21, Speech development has been slow:
22, Speech is not clear:
23, Reacts adversely to changes in routine;
Both
Y^s
Yes
No
No
No
Constant No
Yes No
Yes No
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
No
126
24, C^nU seem to keep from touching everythinq
and everyone around him; Yes No
25, Not learning in school although seems "bright": Yes No
26, Is child lazy — not trying to do well in school: Yes No 27, Daydreams whild doing homework assignments; Yes No
28, Knows work orally at home -- gets to school and has to write it down —. fails miserably; Yes No
127
APPENDIX F; BEHAVIOR CHECKLIST
Please place a check next to those items which are characteristic
of .
CChild's name)
Often f a i l s to f i n i s h things he or she s ta r t s ,
Often doesn't seem to l i s t e n ,
Easily d is t rac ted .
Has d i f f i c u l t y concentrating on schoolwork or other tasks re-requi r ing sustained a t ten t ion .
Has d i f f i c u l t y s t ick ing to a play a c t i v i t y .
Often acts before th ink ing,
Shi f ts excessively from one a c t i v i t y to another,
Has d i f f i c u l t y organizing work,
Needs a l o t of suparvision,
Frequently ca l l s out in class.
Has d i f f i c u l t y awaiting turn in games or group s i tuat ions.
Runs about or climbs excessively,
Has d i f f i c u l t y s i t t i n g s t i l l or f idgets excessively,
Has d i f f i c u l t y staying seated,
Moves about excessively during sleep,
Is always "on the go" or acts as i f "driven by a motor"
Adaoted from: American Psychiatric Association. Diaqnostic and s t a t i s t i c a l manualof mental disorders (3rd Ed.), Washington, D T T T ^ Ãmirican Psychiatric Associat ion, 1980, 43-44,
128
APPENDIX 6; CONNERS' ABRREVIATED TEACHER RATING SCALE
Child's Name
TEACHER'S OBSERVATIQNS
Information obtained
Month Day _By^
Year
OBSERVATION
NOT AT ALL
0
DEGREE OF ACTIVITY
1. Restless or overactive,
2. Excitable, impulsive,
3. Disturbs other children,
4. Fails'to finish things he/she starts, short attention span,
5. Constantly fidgeting,
6. Inattentive, easily distracted,
7. Demands must be met immediately, easily frustrated,
8. Cries often and easily.
9. Mood changes quickly and drastically.
10. Temper outbursts, explosive and un-predictable behavior.
JUST A LITTLE
1
PRETTY MUCH 2
VERY MUCH 3
OTHER OBSERVATIONS OF TEACHER (Use reverse side if more space is needed).
129
APPENDIXK; TEST REPORT FORM
Parents;
Thank you for allowing your child to participate in this study. Your cooperation has been invaluable and is certainly aporeciated, I would n k e to giye you a bit of feedback on the results of the tésts your chnd completed for íne.
Child's Name Date of Test
Basic Viqilance Task: Raw Score Percentile
Correct Detections (Attention)
False Alarms (,errors) (Impulsiveness)
Note; The higher the percentile score the better,
Matching Jamiliar Figures Test Raw Score
Latency
Errors
Explanation and Summary of Results;
If you have any questions about these results please feel free to get in touch with me either in Levelland (894-5858) or in Lubbock (797-1785). I will be glad to meet with you personally and discuss the testing. Thank you again for your lielp with this study.
John C. Simoneaux Project Director
130
APPENDIX I; TEXAS EDUCATION AGENCY GUIDELINES
FOR IDENTIFYING LEARNING DISABLED STUDENTS
(H) Learning Disabled Student
(i) A student who is learning disabled is one who has been deter-mined by a îîiultidisciplinary team not to be achieving commen-surate with his/her age and ability levels. The lack of achievement is found when the student is provided with learning experiences appropriate for his/her age and ability levels in one or íîiore of the following area^; oral expression, listening comprehension, written expression, basic reading skill, read-ing comprehension, mathematics calculation, mathematics rea-soning, or spelling. The term does not include students whose severe discrepancy between ability a'nd achievement is primarily the result of; a visual, hearing, or orthopedic handicap; mental retardation; emotional disturbance; or environmental, cuUural, or economic disadvantage.
Reference
Public Law 94^142 Regulations, Section 121a.540-543.
(.ii) The admission, review, and dismissal committee or multi-disciplinary team may determine that a severe discrepancy .exists as long as the membership of the team includes at least;
(I) the student's regular teacher; or
if the student does not have a regular teacher, a regular classroom teacher qualified to teach a student of his/her age; or for a pre-kindergarten child, an individual certified to teach a child of his/her age; and
(II) a person certified or trained in the area of learning disabilities; and
(III) at least one person certified by the Texas Education Agency to conduct comprehensive assessments of intellec-tual and educational functioning,
At least one team member other than the child's regular teacher shall observe the child's academic performance in a.regular classroom settinr, In the case of pre-kindergarten, a team member shall observe the child in an environment appropriate for a child of that age,
(iii) A severe discrepancy between intellectual ability and academic achievement is defined as one where the student's assessed
131
intellectual functioning is above the mentally retarded range, but where the studenfs assessed educationgl functioning in nlll / î í . - ^ "^°^^ ^^3" o"e standard deviation below the f^ .? / . ^ ^ ' ^ °^ ^^^e ^^^ student's assessed educa-
tionai tunctiomng in areas specified is more than one standard oeviation below the student's intellectual functioning.
When a student's educational performance is below the mean of tne distnct but consistent with the student's assessed intel-lectual functioning, the student is not eligible to be classi-fied as learning disabled.
(iv) As verification of the team's decision, a written report of the evaluation will be prepared and will include but not be limited to;
(I) the results of an assessment of intellectual functioning showing that the student is not mentally retarded;
(II) the results of an individual educational assessment de-scribing the area(.s) of educational achievement in which the student is deficient and substantiating a severe dis-crepancy between achievement and intellectual ability and the basis for determining each;
(III) a statement of the relevant behavior noted during the observation and the relationship of that behavior to the child's educational functioning;
(IV) a statement of educationally relevant medical findings, if any, either from fhe screening prior to referral or from subsequent examination if needed; and
(V) a statement that the severe discrepancy is not primarily the result of an emotional disturbance; visual, hearing, or orthopedic handicap; cultural differences; environmental causes; or economic disadvantage.
Each team member will certify in writing that he/she either con-curs or dissents with the results of the evaluation as set forth in the written report, If the report does not reflect an individual's conclusions, the dissenting member may proyide a separate statement,
Texas Education Agency, Policies and administrative procedures for the education qf hanr'icapped students. Department of Special Education; Austin, Texas, November, 1979, 25-27,
132
APPENDIX J: VIGILANCE TASK BOOTH
133
APPENDIX Kj AUDIOTAPE RECORDED INSTRUCTIONS
PriorUo Practice^SessTon
Okay listen carefully and I will tell you what we are going to
do, Make yourself comfortable first, Remember, if at any time you
don't feel well, or you need to leave, just raise your hand. Now,
grip the bicycle handle so that you can press the little button on
top, Okay? Here's what I want you to do, As long as you see two
green lights or two red lights, that's okay, just let them go; but,
when you see one green and one red blink at the same time press the
button, Okay? Don't prer.s the button until a red and a green blink
together side by side, Okay? Let's practice it first, Let's prac-
tice it for five minutes, You'll be finished when the two lights
come on and stay on, Okay, let's practice,
Prior to Experimental Session
Now we want you to do the same thing for thirty minutes, Okay?
Now watch the lights and press the button when the red and the green
blink at the same time, anJ do not press it when a red or a green
blink by themselves, Okay? Just like the end of the practice you'll
be finished when the two lights come on and stay on. Okay? Here we
go, Raise your hand if you need anything.
134
APPENDIX Lî DISSERTATION RECORD SHEET
Name;
ID#;
Day of Week;
Age:
School;
Sex;
Time of Test;
Total CDs;
Total FAs;
Total Act;
Total Errors;
Mean Latency;
Classification;
CDs Odd;
CDs Even;'
FAs Odd
FAs Even
Act Odd;
Act Even;
Grade;
IQ:
C Score 1;
C Score 2:
Z Score;
D Score 1
D Score 2
D Score 3
RT Odd;
RT Even;
Err Odd;
Err Even;
\ Viqilance Task Data
1
2
3
4
5
6
Total
1-3-5
2-4-6 1
CD
1
FA
'
AC^ .
- \
1
1
1 •- 1
1
•Matching Familiar Figures Test
Card (answer) Resp, Time Err.
1 (1)
2 (6)
3 (3)
4 (1)
-5 (2)
6 (6)
7 (3)
8 (5)
9 (4)
10 (5)
11 (2)
12 (4)
Total
Odd
Even 1
1 i —
•
1 j
1
1
i
1
1
